Active NPI
Machelle Frances Renfro
- Peer Specialist
- Tulsa, OK
National Provider Identifier
1043916976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 6333 E Skelly Dr
Tulsa, OK 74135-6106 - Phone
- (918) 664-4224
- NPI assigned
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
6333 E Skelly Dr
Tulsa, OK 74135-6106
Mailing address
3821 S Rolling Oaks Dr
Tulsa, OK 74107-4872
Phone (539) 250-8704
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M082777404 | Medicaid | OK | |
| 082777404 | Other | OK | DRIVERS LICENSE |
| 082777404 | Other | OK | SOONER CARE |
| 082777404 | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1043916976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3821 S ROLLING OAKS DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741074872",
"telephone_number": "539-250-8704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6333 E SKELLY DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741356106",
"telephone_number": "918-664-4224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENFRO",
"first_name": "MACHELLE",
"middle_name": "FRANCES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "M082777404",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "082777404",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOONER CARE",
"identifier": "082777404",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "082777404",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.