Kimberley Joye Hadrava

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

215 NE 1St St
Wagoner, OK 74467-4439

Phone

(918) 201-4333

NPI assigned

Aug 21, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1710710207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NE 1ST ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674439",
            "telephone_number": "918-201-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NE 1ST ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674439",
            "telephone_number": "918-201-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADRAVA",
        "first_name": "KIMBERLEY",
        "middle_name": "JOYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Plains Sleep Specialists LLC
• Sarah Jayne Greenman
• Karalee Gregg, BS MS
• April Louise Gunter
• William J Guthrie, D.O.
• Amie Hahn
• Robert Dean Hamilton, BSW
• Andrea Hamlet
• Bryan Casey Hanna, M.D.
• Jessica Louise Hardcastle

• Peer Specialist in Wagoner, OK
• Providers in Wagoner, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.