Misty D Tom

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

10343 SW 140TH Rd
Wilburton, OK 74578-6858

Phone

(918) 429-8742

NPI assigned

Oct 22, 2020

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1558960302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10343 SW 140TH RD",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745786858",
            "telephone_number": "918-429-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10343 SW 140TH RD",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745786858",
            "telephone_number": "918-429-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOM",
        "first_name": "MISTY",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Marie Stevens, M.ED., LADC UNDER SU
• Tawnee D Taylor, PHARM. D
• Tidwell Healthcare, LLC (Tidwell Living Center)
• Darren Tidwell, DPH
• Crystal Renee Toland
• Ricardo Mariano Valbuena, MD
• Robert Eugene Vandiver II, P.A.
• Veritas Properties LLC (Main Street Drug)
• Veritas Properties LLC (Main Street Drug)
• Caleb Seth Vinson, MS LPC

• Case Manager/Care Coordinator in Wilburton, OK
• Providers in Wilburton, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.