NPIMap

Organization Active NPI

Edwin Fair CMHC

  • Case Management Agency
  • Ponca City, OK
National Provider Identifier
1407017262
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
EDWIN FAIR CMHC
Practice address
1500 N 6TH St
Ponca City, OK 74601-2827
Phone
(580) 762-7561
Fax
(580) 762-2576
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Mr. Geoffery Homer Cowan, LPC
Title
Executive Director
Phone
(580) 762-7561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1500 N 6TH St
Ponca City, OK 74601-2827

Mailing address

1500 N 6TH St
Ponca City, OK 74601-2827
Phone (580) 762-7561

Other identifiers 1

IdentifierTypeStateIssuer
100749540CMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Edwin Fair CMHC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1500 N 6th St
Ponca City, OK 74601
Phone (580) 762-7561

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1407017262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N 6TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012827",
            "telephone_number": "580-762-7561",
            "fax_number": "580-762-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N 6TH ST",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012827",
            "telephone_number": "580-762-7561",
            "fax_number": "580-762-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN FAIR CMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "GEOFFERY",
        "authorized_official_middle_name": "HOMER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-762-7561",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100749540C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.