Greg Fent

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

304 N Mickey Mantle Blvd
Commerce, OK 74339-1110

Phone

(918) 675-4100

NPI assigned

Jan 13, 2016

Sex

Male

Sole proprietor

Yes

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.

• Northeastern Oklahoma Council on Alcoholism, Inc.

  • Substance Abuse Rehabilitation Facility
  • Commerce, OK
  • NPI 1336346279
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 13, 2016.

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1245696756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N MICKEY MANTLE BLVD",
            "city": "COMMERCE",
            "state": "OK",
            "postal_code": "743391110",
            "telephone_number": "918-675-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N MICKEY MANTLE BLVD",
            "city": "COMMERCE",
            "state": "OK",
            "postal_code": "743391110",
            "telephone_number": "918-675-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENT",
        "first_name": "GREG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jean Callahan
• Commerce Public Schools
• Community Health Center of Northeast Oklahoma, Inc.
• Michelle Deshazer, RN
• Eastwood Manor, LLC
• Johnny Frost
• Joseph Goldman
• Lisha Lancaster
• Northeastern Oklahoma Council on Alcoholism, Inc.
• Tracy Leann Rider

• All providers in Commerce, OK
• Addiction (Substance Use Disorder) Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.

Verify at the official NPI Registry.