Jessie Lou Poahway

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

615 N Main St
Altus, OK 73521-3111

Phone

(580) 471-1855

NPI assigned

Feb 27, 2023

Last updated

May 2, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Hopeful Grounds Association

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Altus, OK
  • NPI 1477340651
  NPD

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1316646672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 N THOMAS ST APT 14",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735212852",
            "telephone_number": "580-318-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N MAIN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735213111",
            "telephone_number": "580-471-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POAHWAY",
        "first_name": "JESSIE",
        "middle_name": "LOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lonnie Edwin Perryman Jr., M.D.
• Bradley Scott Pickett, D.PH.
• David Eugene Pickett, D.PH.
• Greg Daniel Pickett, D.O.
• Picketts Clinic Pharmacy Inc (Clinic Pharmacy)
• Jessica Lanae Poe, CRNA
• Coire Elaine Porter
• Roxie R Powell
• Leeann Marie Prado, SLP-A
• William Alan Prazak, SR. BHCM

• Peer Specialist in Altus, OK
• Providers in Altus, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.