Individual provider Active NPI

Jim L Parker

  • Peer Specialist
  • Pawhuska, OK
National Provider Identifier
1780845719
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
365 Issued in OK
Practice address
473 Elks Lodge Rd
Pawhuska, OK 74056-6542
Phone
(539) 212-2499
Fax
(539) 212-2468
NPI assigned
Jun 23, 2008
Last updated
Jan 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X 365 OK Primary

Addresses

Primary practice location

473 Elks Lodge Rd
Pawhuska, OK 74056-6542

Mailing address

473 Elks Lodge Rd
Pawhuska, OK 74056-6542
Phone (539) 212-2499

Other identifiers 1

IdentifierTypeStateIssuer
365OtherOKCADC

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

State licenses

LicenseStateTypeSpecialty
365OKMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Osage Nation Osage Nation Counseling Center Addiction (Substance Use Disorder) PastSince Jul 9, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1780845719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 ELKS LODGE RD",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740566542",
            "telephone_number": "539-212-2499",
            "fax_number": "539-212-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 ELKS LODGE RD",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740566542",
            "telephone_number": "539-212-2499",
            "fax_number": "539-212-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JIM",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": "365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "365",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawhuska, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; 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.