Individual provider Active NPI

Joelisha Ray'Von Fairbanks, DOULA

  • Doula
  • Midwest City, OK
National Provider Identifier
1114520665
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
7901 NE 10TH St Ste B101
Midwest City, OK 73110-3653
Phone
(405) 795-3733
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X OK Primary

Addresses

Primary practice location

7901 NE 10TH St Ste B101
Midwest City, OK 73110-3653

Mailing address

1809 S Grand Blvd
Oklahoma City, OK 73108-4232
Phone (918) 873-0250

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Intune Mother Society CurrentSince Nov 22, 2020 Accepting new patients
Beehive Birth Consulting Doula CurrentSince Feb 18, 2024 Accepting new patients

Locations

7901 NE 10th St
Ste B101
Midwest City, OK 73110
Phone (405) 250-8910

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1114520665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 S GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731084232",
            "telephone_number": "918-873-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 NE 10TH ST STE B101",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731103653",
            "telephone_number": "405-795-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "JOELISHA",
        "middle_name": "RAY'VON",
        "name_prefix": "Mrs.",
        "credential": "DOULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.