Active NPI
Patricia Hercules
- Counselor
- Tulsa, OK
National Provider Identifier
1679930853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 650 S Peoria Ave
Tulsa, OK 74120-4429 - Phone
- (918) 841-0008
- NPI assigned
- Jan 20, 2016
- 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 |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | J082676900 | OK | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
650 S Peoria Ave
Tulsa, OK 74120-4429
Mailing address
1045 N Narcissus Ave
Broken Arrow, OK 74012-1469
Phone (918) 841-0008
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J082676900 | OK | MD | Case Management Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627257600000",
"number": "1679930853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 N NARCISSUS AVE",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740121469",
"telephone_number": "918-841-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 S PEORIA AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741204429",
"telephone_number": "918-841-0008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERCULES",
"first_name": "PATRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-20",
"last_updated": "2021-07-26",
"certification_date": "2021-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "OK",
"license": "J082676900",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.