NPIMap

Organization Active NPI

Jim Taliaferro CMHC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Anadarko, OK
National Provider Identifier
1285779314
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0005111 Issued in OK
Legal business name
JIM TALIAFERRO CMHC
Practice address
110 SE 2ND Street
Anadarko, OK 73005-3416
Phone
(580) 248-5780
Fax
(580) 353-3202
NPI assigned
Feb 20, 2007
Last updated
Jun 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Authorized official

Name
Mrs. Brenda Ototivo, LBP, LADCNPI 1184820631
Title
Executive Director
Phone
(580) 248-5780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0005111 OK Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

110 SE 2ND Street
Anadarko, OK 73005-3416

Mailing address

110 SE 2ND Street
Anadarko, OK 73005-3416
Phone (580) 248-5780

Other identifiers 2

IdentifierTypeStateIssuer
100706940IMedicaidOK
100706940DMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Oklahoma Forensic Center140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

110 SE 2nd St
Anadarko, OK 73005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1285779314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SE 2ND STREET",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730053416",
            "telephone_number": "580-248-5780",
            "fax_number": "580-353-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SE 2ND STREET",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730053416",
            "telephone_number": "580-248-5780",
            "fax_number": "580-353-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM TALIAFERRO CMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "OTOTIVO",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-248-5780",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LBP, LADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OK",
            "license": "0005111",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100706940I",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100706940D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anadarko, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.