Individual provider Active NPI

Jennifer Conner

  • Counselor
  • Choctaw, OK
National Provider Identifier
1043437163
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
14453 SE 29TH St Ste D
Choctaw, OK 73020-6543
Phone
(405) 741-2844
Fax
(405) 733-1334
NPI assigned
Apr 19, 2007
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

14453 SE 29TH St Ste D
Choctaw, OK 73020-6543

Mailing address

54311 Moccasin Trail Rd
Prague, OK 74864-1121

Other names 1

  • Jennifer Dye Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402002773 OK Practitioner - Mental Health Counselor 8224476866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sac and Fox NationGroup PAC ID 2668361379, 14 clinicians

Practice addresses (Care Compare)

356110 E 930 Rd
Stroud, OK 74079-5184
Phone 91896895313035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Poyner Psychological Services, Inc. CurrentSince Nov 22, 2020 Accepting new patients
Poyner Mental Health Services CurrentSince Jan 4, 2024 Accepting new patients
Sac & Fox Nation CurrentSince Jun 19, 2025 Accepting new patients

Locations

14453 SE 29th St
Ste D
Choctaw, OK 73020
Phone (405) 741-2844

356110 E 930 Rd
Stroud, OK 74079
Phone (918) 968-9531

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1043437163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54311 MOCCASIN TRAIL RD",
            "city": "PRAGUE",
            "state": "OK",
            "postal_code": "748641121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14453 SE 29TH ST STE D",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730206543",
            "telephone_number": "405-741-2844",
            "fax_number": "405-733-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Choctaw, OK

Sources for this page

Verify at the official NPI Registry.