Steven Petty II

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

10025 S 705 Rd
Wyandotte, OK 74370-9507

Phone

(918) 303-5433

Fax

(918) 615-9666

NPI assigned

Jan 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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 and National Provider Directory roles.

• Modoc Nation Behavioral Health

  • Multi-Specialty Clinic/Center
  • Wyandotte, OK
  • NPI 1265083380
  NPD

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1548911423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10025 S 705 RD",
            "city": "WYANDOTTE",
            "state": "OK",
            "postal_code": "743709507",
            "telephone_number": "918-303-5433",
            "fax_number": "918-615-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 S 705 RD",
            "city": "WYANDOTTE",
            "state": "OK",
            "postal_code": "743709507",
            "telephone_number": "918-303-5433",
            "fax_number": "918-615-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "STEVEN",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-12",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Hart, PMHNP
• Lori A Hill
• Samantha Kathleen Mason
• Justice Maria Mills
• Modoc Nation Behavioral Health
• Cherie Ann Riley, LPMT-BC
• Jill Roberts, BS, CADC
• Jamie Dawn Simmons, MSW, LMSW
• Deana Gayle Sweatt, PHARM.D.
• Turkey Ford School

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.