NPIMap

Organization Active NPI

State of Oklahoma

  • Community/Behavioral Health Agency
  • Kingfisher, OK
National Provider Identifier
1285707406
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STATE OF OKLAHOMA
Practice address
Northwest Center for Behavioral Health
124 E. Sheridan
Kingfisher, OK 73750
Phone
(405) 375-6377
Fax
(405) 375-6377
NPI assigned
Nov 16, 2006
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Trudy Hoffman
Title
Executive Director
Phone
(580) 571-3233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

Northwest Center for Behavioral Health
124 E. Sheridan
Kingfisher, OK 73750

Mailing address

Northwest Center for Behavioral Health
1222 10TH Street, Suite 211
Woodward, OK 73801-3156
Phone (580) 571-3217

Other identifiers 1

IdentifierTypeStateIssuer
100646280BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000846 OK Part B Supplier - Clinic/Group Practice 4486558962 Receives reassigned benefits from 175 practitioners
32 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alva, OK; Woodward, OK; Tulsa, OK; Stigler, OK; Norman, OK; McAlester, OK; Lawton, OK; Kingfisher, OK…

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1285707406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
            "address_2": "1222 10TH STREET, SUITE 211",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013156",
            "telephone_number": "580-571-3217",
            "fax_number": "580-256-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHWEST CENTER FOR BEHAVIORAL HEALTH",
            "address_2": "124 E. SHERIDAN",
            "city": "KINGFISHER",
            "state": "OK",
            "postal_code": "73750",
            "telephone_number": "405-375-6377",
            "fax_number": "405-375-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-571-3233"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100646280B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingfisher, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.