Active NPI
Kerry Gene Young
- Peer Specialist
- Chouteau, OK
National Provider Identifier
1093470130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 101 N McCracken St
Chouteau, OK 74337-3219 - Phone
- (539) 900-5485
- NPI assigned
- Nov 3, 2021
- 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
101 N McCracken St
Chouteau, OK 74337-3219
Mailing address
101 N McCracken St
Chouteau, OK 74337-3219
Phone (539) 900-5485
Other names 1
- Kerry Gene Graham
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": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1093470130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 N MCCRACKEN ST",
"city": "CHOUTEAU",
"state": "OK",
"postal_code": "743373219",
"telephone_number": "539-900-5485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N MCCRACKEN ST",
"city": "CHOUTEAU",
"state": "OK",
"postal_code": "743373219",
"telephone_number": "539-900-5485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "KERRY",
"middle_name": "GENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-03",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KERRY",
"last_name": "GRAHAM",
"middle_name": "GENE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chouteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.