NPIMap

Organization Active NPI

Lanai P, PC

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
National Provider Identifier
1811238868
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
908 Issued in OK
Legal business name
LANAI P, PC
Practice address
310 NE 28TH St
Ste. 204
Oklahoma City, OK 73105-2806
Phone
(405) 601-4565
Fax
(405) 601-4579
NPI assigned
Mar 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Dr. Mariechia L Palmer, PHDNPI 1568792547
Title
Owner
Phone
(405) 623-1976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 908 OK
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 1077 OK
Community/Behavioral Health Agency 251S00000X 908 OK Primary

Addresses

Primary practice location

310 NE 28TH St
Ste. 204
Oklahoma City, OK 73105-2806

Mailing address

310 NE 28TH St
Ste. 204
Oklahoma City, OK 73105-2806
Phone (405) 601-4565

Other identifiers 2

IdentifierTypeStateIssuer
200491750AMedicaidOK
200491750BMedicaidOK

Other names 1

  • Spring Eternal Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240314003077 OK Part B Supplier - Clinic/Group Practice 7517303365 Receives reassigned benefits from 3 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

310 NE 28th St
Ste 204
Oklahoma City, OK 73105
Phone (405) 601-4565

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1811238868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NE 28TH ST",
            "address_2": "STE. 204",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731052806",
            "telephone_number": "405-601-4565",
            "fax_number": "405-601-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NE 28TH ST",
            "address_2": "STE. 204",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731052806",
            "telephone_number": "405-601-4565",
            "fax_number": "405-601-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANAI P, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "MARIECHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-623-1976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "908",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "1077",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200491750A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200491750B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Eternal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.