Individual provider Active NPI

Joey Wade Jeane

  • Peer Specialist
  • Enid, OK
National Provider Identifier
1518626134
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1824 S Van Buren St
Enid, OK 73703-7903
Phone
(405) 230-1181
NPI assigned
Dec 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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 OK Primary

Addresses

Primary practice location

1824 S Van Buren St
Enid, OK 73703-7903

Mailing address

Catalyst
1824 S Van Buren
Enid, OK 73703
Phone (405) 230-1181

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

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1518626134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CATALYST",
            "address_2": "1824 S VAN BUREN",
            "city": "ENID",
            "state": "OK",
            "postal_code": "73703",
            "telephone_number": "405-230-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 S VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737037903",
            "telephone_number": "405-230-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANE",
        "first_name": "JOEY",
        "middle_name": "WADE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.