Active NPI
James Keith Schardein II, CADC
- Addiction (Substance Use Disorder) Counselor
- Pryor, OK
National Provider Identifier
1710187711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 104
- Practice address
- 205 S Adair St
Pryor, OK 74361-5201 - Phone
- (918) 825-4872
- Fax
- (918) 825-4873
- NPI assigned
- Jul 19, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 104 | OK | Primary |
Addresses
Primary practice location
205 S Adair St
Pryor, OK 74361-5201
Mailing address
205 S Adair St
Pryor, OK 74361-5201
Phone (918) 825-4872
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 |
|---|---|---|---|
| 104 | OK | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pushmataha Counseling Services, Inc. | Past | Accepting new patients | |
| Pushmataha Counseling Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Pryor, OK
- NPI 1508065970
-
- Community/Behavioral Health Agency
- Pryor, OK
- NPI 1588808109
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1710187711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 S ADAIR ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743615201",
"telephone_number": "918-825-4872",
"fax_number": "918-825-4873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S ADAIR ST",
"city": "PRYOR",
"state": "OK",
"postal_code": "743615201",
"telephone_number": "918-825-4872",
"fax_number": "918-825-4873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHARDEIN",
"first_name": "JAMES",
"middle_name": "KEITH",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-19",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OK",
"license": "104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.