NPIMap

Organization Active NPI

Edwin Fair Community Mental Health Center

  • Case Management Agency
  • Ponca City, OK
National Provider Identifier
1831218296
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
EDWIN FAIR COMMUNITY MENTAL HEALTH CENTER
Practice address
201 E Chestnut Ave
Ponca City, OK 74601-4311
Phone
(580) 763-0931
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Geoff Cowan, LPC
Title
Executive Director
Phone
(580) 761-5608

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OK Primary
Case Management Agency 251B00000X 171M00000X OK

Addresses

Primary practice location

201 E Chestnut Ave
Ponca City, OK 74601-4311

Mailing address

3542 Springwood St Apt 604
Ponca City, OK 74604-1632
Phone (580) 716-1731

National Provider Directory

National Provider Directory
Tax ID family
Edwin Fair CMHC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831218296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3542 SPRINGWOOD ST APT 604",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746041632",
            "telephone_number": "580-716-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E CHESTNUT AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746014311",
            "telephone_number": "580-763-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN FAIR COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "GEOFF",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-761-5608",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OK",
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OK",
            "license": "171M00000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.