Active NPI
Brenda Henriquez
- Case Manager/Care Coordinator
- Pryor, OK
National Provider Identifier
1326602467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- Y084170766
- Practice address
- 109 N Fairland St
Pryor, OK 74361-4203 - Phone
- (918) 825-1405
- Fax
- (918) 825-1406
- NPI assigned
- Apr 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Y084170766 | OK | Primary |
Addresses
Primary practice location
109 N Fairland St
Pryor, OK 74361-4203
Mailing address
109 N Fairland St
Pryor, OK 74361-4203
Phone (918) 825-1405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
114 W Delaware Ave
Nowata, OK 74048-2601
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Y084170766 | OK | MD | Case Manager/Care Coordinator |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Miami, OK
- NPI 1497762520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561334400000",
"number": "1326602467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 N FAIRLAND ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743614203",
"telephone_number": "918-825-1405",
"fax_number": "918-825-1406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N FAIRLAND ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743614203",
"telephone_number": "918-825-1405",
"fax_number": "918-825-1406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIQUEZ",
"first_name": "BRENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-24",
"last_updated": "2019-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OK",
"license": "Y084170766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.