Kristen Renea Harris

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1095 Nickerson St
Waynoka, OK 73860-1252

Phone

(580) 824-0674

Fax

(580) 824-0676

NPI assigned

Jun 11, 2021

Last updated

Jun 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristen Renea Bellmon Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waynoka Mental Health Authority

  dba Northwest Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Waynoka, OK
  • NPI 1376991737
  NPD (past)
• Waynoka Mental Health Authority

  dba Northwest Substance Abuse Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Waynoka, OK
  • NPI 1942334768
  NPD (past)

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1265000889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738600135",
            "telephone_number": "580-824-0674",
            "fax_number": "580-824-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 NICKERSON ST",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738601252",
            "telephone_number": "580-824-0674",
            "fax_number": "580-824-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KRISTEN",
        "middle_name": "RENEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942334768",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kharrisnwtc@plsi.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1095 Nickerson St",
            "city": "Waynoka",
            "state": "OK",
            "country_code": "US",
            "postal_code": "738601252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BELLMON",
            "middle_name": "RENEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marsha Lynnette Cunningham
• Jerry Lee Dennis, D.PH.
• Ashley Nicole Ferguson, BS IN SOCIAL WORK
• Clarissa M Fifield, LCSW
• Dian Linnea Frey
• Marissa Hofen
• Christy Jo Hood
• Integris Bass Baptist Health Center (Integris Health Medical Group Waynoka)
• Jerrys Pharmacy
• Bobbie Jean Jones

• Case Manager/Care Coordinator in Waynoka, OK
• Providers in Waynoka, 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 Jun 11, 2021; 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.