Active NPI
Keli Jo Spears
- Case Manager/Care Coordinator
- Wilburton, OK
National Provider Identifier
1619539541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 10975 SW Hwy 1
Wilburton, OK 74578 - Phone
- (918) 429-2819
- NPI assigned
- Jul 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
10975 SW Hwy 1
Wilburton, OK 74578
Mailing address
PO Box 54
Hartshorne, OK 74547-0054
Phone (918) 429-2819
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": "1561939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590364800000",
"number": "1619539541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 54",
"city": "HARTSHORNE",
"state": "OK",
"postal_code": "745470054",
"telephone_number": "918-429-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10975 SW HWY 1",
"city": "WILBURTON",
"state": "OK",
"postal_code": "74578",
"telephone_number": "918-429-2819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEARS",
"first_name": "KELI",
"middle_name": "JO",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-01",
"last_updated": "2020-05-25",
"certification_date": "2020-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilburton, OK
- S-Okla Psychological Services, Inc.
- Kallie Lenn Shaffett
- Catherine Sonaggera Knight
- Southern Oklahoma Treatment Services, Inc
- Southern Oklahoma Treatment Services, Inc.
- Riley Sheyenne Spears
- Kevin Don Stansel, MS LPC #4291
- Tara Marie Stevens, M.ED., LADC UNDER SU
- Tawnee D Taylor, PHARM. D
- Tidwell Healthcare, LLC (Tidwell Living Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.