Active NPI
Jessica Neely
- Peer Specialist
- Ramona, OK
National Provider Identifier
1225499783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- H083291088
- Practice address
- 403030 W 2700 Rd
Ramona, OK 74061-3543 - Phone
- (470) 214-6118
- NPI assigned
- Mar 11, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | H083291088 | OK | Primary |
Addresses
Primary practice location
403030 W 2700 Rd
Ramona, OK 74061-3543
Mailing address
403030 W 2700 Rd
Ramona, OK 74061-3543
Phone (470) 214-6118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H083291088 | Other | OK | H083291088 |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H083291088 | OK | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457654400000",
"number": "1225499783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403030 W 2700 RD",
"city": "RAMONA",
"state": "OK",
"postal_code": "740613543",
"telephone_number": "470-214-6118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403030 W 2700 RD",
"city": "RAMONA",
"state": "OK",
"postal_code": "740613543",
"telephone_number": "470-214-6118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEELY",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-11",
"last_updated": "2016-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OK",
"license": "H083291088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "H083291088",
"identifier": "H083291088",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ramona, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.