Individual provider Active NPI

Tamesha Shanette Brown

  • Community/Behavioral Health Agency
  • Midwest City, OK
National Provider Identifier
1710659776
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
7117 E Reno Ave
Midwest City, OK 73110-4444
Phone
(405) 610-5242
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 1

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

Addresses

Primary practice location

7117 E Reno Ave
Midwest City, OK 73110-4444

Mailing address

PO Box 96142
Oklahoma City, OK 73143-6142
Phone (405) 706-5002

Other identifiers 1

IdentifierTypeStateIssuer
1134671951MedicaidOK

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": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1710659776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96142",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731436142",
            "telephone_number": "405-706-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 E RENO AVE",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731104444",
            "telephone_number": "405-610-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TAMESHA",
        "middle_name": "SHANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134671951",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.

Verify at the official NPI Registry.