Individual provider Active NPI

Kierra Tashae Roberson

  • Case Manager/Care Coordinator
  • Oklahoma City, OK
National Provider Identifier
1801606850
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
3000 United Founders Blvd Ste 124
Oklahoma City, OK 73112-4292
Phone
(405) 761-0695
NPI assigned
Jan 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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 OK Primary

Addresses

Primary practice location

3000 United Founders Blvd Ste 124
Oklahoma City, OK 73112-4292

Mailing address

PO Box 721581
Oklahoma City, OK 73172-1581
Phone (405) 761-0695

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

NPI Registry JSON

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1801606850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721581",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731721581",
            "telephone_number": "405-761-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 UNITED FOUNDERS BLVD STE 124",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124292",
            "telephone_number": "405-761-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "KIERRA",
        "middle_name": "TASHAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.