Individual provider Active NPI

Kesha Dawn Axtell

  • Peer Specialist
  • Weatherford, OK
National Provider Identifier
1386526028
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
136602 Issued in OK
Practice address
2250 N Airport Rd
Weatherford, OK 73096-3351
Phone
(580) 819-1889
NPI assigned
Jul 23, 2025
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 136602 OK Primary

Addresses

Primary practice location

2250 N Airport Rd
Weatherford, OK 73096-3351

Mailing address

2250 N Airport Rd
Weatherford, OK 73096-3351
Phone (580) 819-1889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
136602OKMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1386526028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 N AIRPORT RD",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963351",
            "telephone_number": "580-819-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 N AIRPORT RD",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730963351",
            "telephone_number": "580-819-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXTELL",
        "first_name": "KESHA",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": "136602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.