Michelle Gann

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

618 E Hartford Ave
Ponca City, OK 74601-2005

Phone

(580) 686-0202

NPI assigned

Dec 11, 2023

Last updated

Dec 11, 2023By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avenue of Hope Assoc.

  • Peer Specialist
  • Ponca City, OK
  • NPI 1578335030
  NPD

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1609643634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746020182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 E HARTFORD AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012005",
            "telephone_number": "580-686-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANN",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary E Fultz III
• Heather Dawn Fusselman
• Willow Lee Gahr
• Courtney Gallimore
• Christine J Gann
• Edgar Garcia
• Melanie Gartside
• Gary a Dorman
• Stefan Jacob Gelven, DDS
• Kathy George

• Peer Specialist in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.