James Robert Henson – Peer Specialist in Maud, OK

Key facts

NPI: 1083391676
Entity type: Individual (NPI type 1)
Primary specialty: Peer Specialist 175T00000X
Practice address: Clay Crossing Foundation, 32018 Hwy 59
Maud, OK 74854
Phone: (405) 374-1225
NPI assigned: Jul 5, 2023
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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

Clay Crossing Foundation Inc Community/Behavioral Health Agency · Maud, OK · NPI 1508999319

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Clay Crossing Foundation Inc		Past since Jul 9, 2023	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Peer Specialist	175T00000X			Yes

Addresses

Primary practice location

Clay Crossing Foundation, 32018 Hwy 59
Maud, OK 74854

Mailing address

Clay Crossing Foundation, P.O Box 8, 32018 Hwy 59
Maud, OK 74854

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 9, 2023.

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1083391676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLAY CROSSING FOUNDATION, P.O BOX 8, 32018 HWY 59",
            "city": "MAUD",
            "state": "OK",
            "postal_code": "74854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLAY CROSSING FOUNDATION, 32018 HWY 59",
            "city": "MAUD",
            "state": "OK",
            "postal_code": "74854",
            "telephone_number": "405-374-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maud, OK

All providers in Maud, OK · Peer Specialist in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.