Active NPI
Misti Dawn Jackson-Hise
- Case Manager/Care Coordinator
- Poteau, OK
National Provider Identifier
1770100604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 309 Rogers Ave
Poteau, OK 74953-4227 - Phone
- (918) 658-8078
- NPI assigned
- Jun 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
309 Rogers Ave
Poteau, OK 74953-4227
Mailing address
PO Box 3
Talihina, OK 74571-0003
Phone (918) 413-1100
Other practice location 1
123 E Avenue C
Heavener, OK 74937-2603
Phone (918) 658-4016
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Counseling, Inc | Mental Health | Past | Accepting new patients |
| A Plus Care Program LLC | Mental Health | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Heavener, OK
- NPI 1891331187
-
- Mental Health Counselor
- Heavener, OK
- NPI 1003386418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593129600000",
"number": "1770100604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3",
"city": "TALIHINA",
"state": "OK",
"postal_code": "745710003",
"telephone_number": "918-413-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 ROGERS AVE",
"city": "POTEAU",
"state": "OK",
"postal_code": "749534227",
"telephone_number": "918-658-8078"
}
],
"practiceLocations": [
{
"address_1": "123 E Avenue C",
"address_purpose": "LOCATION",
"city": "Heavener",
"state": "OK",
"postal_code": "749372603",
"country_code": "US",
"telephone_number": "918-658-4016",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON-HISE",
"first_name": "MISTI",
"middle_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-26",
"last_updated": "2020-06-26",
"certification_date": "2020-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.