Carissa Trinette Jones, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

0104860 Issued in OK

Practice address

105365 S Highway 102
McLoud, OK 74851-3051

Phone

(405) 964-2081

Fax

(405) 964-2170

NPI assigned

Dec 17, 2020

Last updated

Dec 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1760078323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105365 S HIGHWAY 102",
            "city": "MCLOUD",
            "state": "OK",
            "postal_code": "748513051",
            "telephone_number": "405-964-2081",
            "fax_number": "405-964-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105365 S HIGHWAY 102",
            "city": "MCLOUD",
            "state": "OK",
            "postal_code": "748513051",
            "telephone_number": "405-964-2081",
            "fax_number": "405-964-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CARISSA",
        "middle_name": "TRINETTE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OK",
            "license": "0104860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION BOARD FOR DIABETES CARE AND EDUCATION",
            "identifier": "22200767",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Heath Hobbs
• Rodney Mitchell Hutchins, D.D.S.
• Meredith Nicole Jacquemin, RN, IBCLC
• Jae W. Choi DDS PLLC (Mcloud Dental Center)
• Jennifer Allen Therapy and Consultation LLC (Jatc)
• Kathryn Dean Jones, PHARM D
• Annelise Kampschaefer
• Keith a. Mehner, D.D.S.,P.L.L.C (McLoud Family Dentistry)
• Kickapoo Behavioral Health
• Kickapoo Health Center

• Diabetes Educator Registered Nurse in McLoud, OK
• Providers in McLoud, OK by specialty
• Diabetes Educator Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.