Individual provider Active NPI

Tiffany Deann Patterson

  • Case Manager/Care Coordinator
  • Durant, OK
National Provider Identifier
1750912010
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
1001 W Main St
Durant, OK 74701-5038
Phone
(580) 924-7330
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

1001 W Main St
Durant, OK 74701-5038

Mailing address

1001 W Main St
Durant, OK 74701-5038
Phone (580) 924-7330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110002633 OK Practitioner - Mental Health Counselor 5698126092 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11115OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Wellness Centers CurrentSince Jan 1, 2024 Accepting new patients
Lighthouse Behavioral Wellness Centers CurrentSince Jan 1, 2024 Accepting new patients

Locations

2530 S Commerce St
Bldg B
Ardmore, OK 73401
Phone (580) 319-7305

1001 W Main St
Durant, OK 74701
Phone (580) 924-7330

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1750912010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W MAIN ST",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747015038",
            "telephone_number": "580-924-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W MAIN ST",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747015038",
            "telephone_number": "580-924-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "TIFFANY",
        "middle_name": "DEANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

Verify at the official NPI Registry.