Perpetua Petersen, CARE COORDINATOR

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

713 SW C Ave
Lawton, OK 73501-4311

Phone

(866) 926-6552

NPI assigned

Dec 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Perpetua Obono Eyene Obono Former name

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 and National Provider Directory roles.

• Yco Tulsa, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lawton, OK
  • NPI 1629400288
  NPD (past)

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

{
    "created_epoch": "1545523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545523200000",
    "number": "1669944062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NE FLOWER MOUND RD LOT 183",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735077222",
            "telephone_number": "520-495-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 SW C AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735014311",
            "telephone_number": "866-926-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "PERPETUA",
        "credential": "CARE COORDINATOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-23",
        "last_updated": "2018-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PERPETUA",
            "last_name": "OBONO EYENE OBONO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sirisha Perumandla, MD
• Ivory Nicole Perusse
• Randy Perusse
• Antwayne Peters
• Samuel Peters I
• Neli Petkova
• Anke Peyton, LPC CANDIDATE
• PF Lawton SNF Ops, LLC
• Shelley Ozio Phelps, LPC
• Phenyx Home Care LLC

• All providers in Lawton, OK
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2018; 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.