Wanda W Priddy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3383 Issued in OK

Practice address

301 N 2ND St
Fairfax, OK 74637-2012

Phone

(918) 642-3515

Fax

(918) 642-3519

NPI assigned

Feb 27, 2008

Last updated

Jun 2, 2008By 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

Other names 1

• Wanda E Wahnee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AGHIAA

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.

• Fairfax Medical Facilities, Inc.

  dba Ponca City Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Ponca City, OK
  • NPI 1316747017
  NPD (past)

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1780853382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N MAIN ST",
            "city": "FAIRFAX",
            "state": "OK",
            "postal_code": "746373023",
            "telephone_number": "918-642-3100",
            "fax_number": "918-642-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 2ND ST",
            "city": "FAIRFAX",
            "state": "OK",
            "postal_code": "746372012",
            "telephone_number": "918-642-3515",
            "fax_number": "918-642-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDDY",
        "first_name": "WANDA",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3383",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "WAHNEE",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zane Grey Mills, DDS
• Oklahoma Advantage Storehouse, LLC
• Oklahoma Home Health LLC
• Osage Skies Hospice Group Inc
• Elmer Gari Owens, P.A.
• Rebecca A Rhodes, APRN,BC
• Rural Wellness Fairfax Inc (Rural Wellness Fairfax Hospital)
• Rural Wellness Fairfax Inc (Rural Wellness Fairfax Clinic)
• Rural Wellness Fairfax Inc (Rural Wellness Fairfax Hospital)
• Shelley G Simon, LCSW

• Clinical Social Worker in Fairfax, OK
• Providers in Fairfax, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.