Timothy Matthew Nida, M.H.R.
Individual provider Active NPI Counselor · Howe, OK
NPI 1649599531 · NPPES record last updated Dec 28, 2012
Key facts
- NPI
- 1649599531
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 959 (OK)
- Practice address
- 39995 RND. Mt LN
Howe, OK 74940 - Phone
- (918) 658-5026
- NPI assigned
- May 18, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240124004681 | TX | Practitioner - Mental Health Counselor | 3476906561 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choctaw Nation of Oklahoma | Current |
Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current |
Accepting new patients | |
| Choctaw Nation of Oklahoma | Past | Accepting new patients |
Locations
1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981
1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204
410 N M St
Hugo, OK 74743
Phone (580) 326-7561
902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600
1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026
109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100
2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200
1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440
205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 959 | OK | Yes |
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
39995 RND. Mt LN
Howe, OK 74940
Mailing address
PO Box 13
Poteau, OK 74953-0013
Phone (918) 658-5026
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100731330-A | Medicaid | OK |
Other names
- Mr. Matt Nida
Other providers in Howe, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.