Ti'Anca Mock

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

320 12TH Ave NE
Norman, OK 73071-5238

Phone

(405) 364-9004

NPI assigned

Jul 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1124637400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 ALLENHURST ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730711414",
            "telephone_number": "832-839-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 12TH AVE NE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715238",
            "telephone_number": "405-364-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "TI'ANCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L082909589",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tianca.mock@odmhsas.org",
            "affiliation": "N",
            "address_1": "2030 Allenhurst St",
            "city": "Norman",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730711414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serena Mitroo, MD
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• Ahmed Mohammed, MD

• Case Manager/Care Coordinator in Norman, OK
• Providers in Norman, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.