NPIMap

Organization Active NPI

Eagle Ridge Institute

  • Case Management Agency
  • Oklahoma City, OK
National Provider Identifier
1104182633
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
7272 Issued in OK
Legal business name
EAGLE RIDGE INSTITUTE
Practice address
601 NE 63Rd St
Oklahoma City, OK 73105-6407
Phone
(405) 840-1359
NPI assigned
Apr 10, 2012
Last updated
Apr 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Mr. John Mayfield, M.DIV.
Title
Executive Director
Phone
(405) 840-1359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 7272 OK Primary

Addresses

Primary practice location

601 NE 63Rd St
Oklahoma City, OK 73105-6407

Mailing address

601 NE 63Rd St
Oklahoma City, OK 73105-6407
Phone (405) 840-1359

National Provider Directory

National Provider Directory
Tax ID family
Eagle Ridge Family Treatment Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1104182633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NE 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731056407",
            "telephone_number": "405-840-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NE 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731056407",
            "telephone_number": "405-840-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RIDGE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "MAYFIELD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "405-840-1359",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.DIV."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OK",
            "license": "7272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.