Active NPI
Tara Stevens
- Case Manager/Care Coordinator
- Kingston, OK
National Provider Identifier
1699213827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 700 Highway 32
Kingston, OK 73439-8073 - Phone
- (580) 565-5030
- Fax
- (580) 565-5056
- NPI assigned
- Feb 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
700 Highway 32
Kingston, OK 73439-8073
Mailing address
238 NW a St
Antlers, OK 74523-2215
Phone (580) 271-2337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45-4724630 | Medicaid | OK |
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": "1486512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486512000000",
"number": "1699213827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 NW A ST",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745232215",
"telephone_number": "580-271-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 HIGHWAY 32",
"city": "KINGSTON",
"state": "OK",
"postal_code": "734398073",
"telephone_number": "580-565-5030",
"fax_number": "580-565-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "TARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-08",
"last_updated": "2017-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "45-4724630",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingston, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.