Individual provider Active NPI

Haneefa Rakeeb, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1568027217
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
220501 Issued in OK
Practice address
701 Cedar Lake Blvd Ste 120
Oklahoma City, OK 73114-7815
Phone
(405) 445-1210
NPI assigned
May 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 220501 OK Primary

Addresses

Primary practice location

701 Cedar Lake Blvd Ste 120
Oklahoma City, OK 73114-7815

Mailing address

701 Cedar Lake Blvd Ste 120
Oklahoma City, OK 73114-7815
Phone (405) 445-1210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217003853 OK Practitioner - Nurse Practitioner 6800323783 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
220501OKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Dec 12, 2024 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Dec 12, 2024 Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

701 Cedar Lake Blvd
Ste 120
Oklahoma City, OK 73114
Phone (405) 286-1170

7127 S Olympia Ave
Tulsa, OK 74132
Phone (918) 665-9500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1568027217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 CEDAR LAKE BLVD STE 120",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147815",
            "telephone_number": "405-445-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 CEDAR LAKE BLVD STE 120",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147815",
            "telephone_number": "405-445-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKEEB",
        "first_name": "HANEEFA",
        "name_prefix": "Ms.",
        "credential": "RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "220501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.