Jacen Byrd

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

7010 S Yale Ave
Tulsa, OK 74136-5713

Phone

(918) 236-4176

NPI assigned

Apr 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Lake Mental Health Center, Inc.Group PAC ID 4688711534, 121 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Grand Lake Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment Care Compare group NPD
• Grand Lake Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kansas, OK
  • NPI 1114458858
  NPD
• Grand Lake Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1871081935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365713",
            "telephone_number": "918-236-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365713",
            "telephone_number": "918-236-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "JACEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Bymaster, PHARMD
• Hannah Beth Bynum
• Audrey Byrd, DO
• Connie Byrd
• Gloria Ann Byrd
• Marissa Jonagan Byrd
• Stephanie Anne Byrd, APRN
• Christina Byrne, CRNA
• Haven Elise Byrne
• Marlene Byrne, LPC

• Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.