| Cedar Ridge Behavioral Hospital | |
|
6501 Ne 50th St Oklahoma City OK 73141-9118 | |
| (405) 605-6111 | |
| (405) 424-0457 |
| Full Name | Cedar Ridge Behavioral Hospital |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6501 Ne 50th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Steve Filton (SR VP CFO) |
| Authorized Official Contact | 6107683300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Ridge Behavioral Hospital 6501 Ne 50th St Oklahoma City OK 73141-9118 Ph: (405) 605-6111 | Cedar Ridge Behavioral Hospital 6501 Ne 50th St Oklahoma City OK 73141-9118 Ph: (405) 605-6111 |
| NPI Number | 1083985600 |
|---|---|
| Provider Enumeration Date | 01/13/2012 |
| Last Update Date | 03/31/2021 |
| Certification Date | 03/31/2021 |
| Medicare PECOS PAC ID | 6507878113 |
|---|---|
| Medicare Enrollment ID | O20150427002122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083985600 | NPI | - | NPPES |
| 100544890C | Medicaid | OK | |
| 200085660B | Medicaid | OK | |
| 200085660D | Medicaid | OK | |
| 200085660A | Medicaid | OK | |
| 200085660C | Medicaid | OK |
| Provider Name | Hashib D Faruque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225006570 PECOS PAC ID: 2365347069 Enrollment ID: I20031205000072 |
| Provider Name | Jawaun M Lewis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922150531 PECOS PAC ID: 7315919222 Enrollment ID: I20040811000468 |
| Provider Name | Yana Jarman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649332214 PECOS PAC ID: 5890899116 Enrollment ID: I20070327000192 |
| Provider Name | William E Tankersley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053402347 PECOS PAC ID: 7810097219 Enrollment ID: I20080729000206 |
| Provider Name | Nathan J Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679733216 PECOS PAC ID: 4587708532 Enrollment ID: I20100215000617 |
| Provider Name | Brett I Cunningham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730315193 PECOS PAC ID: 8820245558 Enrollment ID: I20120830000670 |
| Provider Name | Limei Yang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003049123 PECOS PAC ID: 2466696778 Enrollment ID: I20130926000096 |
| Provider Name | Shyvonne N Gray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639490618 PECOS PAC ID: 6305066044 Enrollment ID: I20160404000036 |
| Provider Name | William Oliva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356781199 PECOS PAC ID: 5991025850 Enrollment ID: I20161028000688 |
| Provider Name | Christopher Snyder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205270725 PECOS PAC ID: 2365720828 Enrollment ID: I20161103001510 |
| Provider Name | Audra Yadack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851611602 PECOS PAC ID: 6800177999 Enrollment ID: I20170104000455 |
| Provider Name | Mark D Holsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992184485 PECOS PAC ID: 2466730957 Enrollment ID: I20170627001283 |
| Provider Name | Ayesha Sattar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104232768 PECOS PAC ID: 1557626181 Enrollment ID: I20180531000537 |
| Provider Name | Tarek Kanaa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639521347 PECOS PAC ID: 8426300179 Enrollment ID: I20181009000897 |
| Provider Name | Hunter M Caskey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164874954 PECOS PAC ID: 5890027114 Enrollment ID: I20191105002632 |
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