NPIMap

Organization Active NPI

Genesi LLC

  • Community/Behavioral Health Agency
  • Moore, OK
National Provider Identifier
1669767257
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GENESI LLC
Practice address
626 N Broadway St
Moore, OK 73160-4814
Phone
(405) 626-1711
Fax
(405) 895-7544
NPI assigned
Jun 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Authorized official

Name
Ms. Rosanne Jill Nardoni Isom, LPC
Title
Ceo/LPC
Phone
(405) 626-2544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OK Primary

Addresses

Primary practice location

626 N Broadway St
Moore, OK 73160-4814

Mailing address

626 N Broadway St
Moore, OK 73160-4814
Phone (405) 626-1711

National Provider Directory

National Provider Directory
Tax ID family
Genesi LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1669767257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N BROADWAY ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604814",
            "telephone_number": "405-626-1711",
            "fax_number": "405-895-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N BROADWAY ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604814",
            "telephone_number": "405-626-1711",
            "fax_number": "405-895-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "NARDONI ISOM",
        "authorized_official_first_name": "ROSANNE",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "CEO/LPC",
        "authorized_official_telephone_number": "405-626-2544",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.