| Millennium Medical Services, L.l.c. | |
|
448 36th Ave Nw Ste 101 Norman OK 73072-4743 | |
| (888) 573-7792 | |
| (888) 753-8162 |
| Full Name | Millennium Medical Services, L.l.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 448 36th Ave Nw Ste 101, Norman, Oklahoma |
| Authorized Official Name and Position | Wade L Hamil (CEO) |
| Authorized Official Contact | 8885737792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Medical Services, L.l.c. 508 Man O War Ct Edmond OK 73025-9512 Ph: (405) 623-0509 | Millennium Medical Services, L.l.c. 448 36th Ave Nw Ste 101 Norman OK 73072-4743 Ph: (888) 573-7792 |
| NPI Number | 1245286285 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 02/22/2022 |
| Certification Date | 02/22/2022 |
| Medicare PECOS PAC ID | 6204730856 |
|---|---|
| Medicare Enrollment ID | O20040105000859 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245286285 | NPI | - | NPPES |
| 200004820A | Medicaid | OK | |
| DA0514 | Other | OK | MEDICARE - RAILROAD GROUP |
| Provider Name | Tonya Valois |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275549651 PECOS PAC ID: 8325947518 Enrollment ID: I20040107000444 |
| Provider Name | Lawren A Merideth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356432637 PECOS PAC ID: 4981684321 Enrollment ID: I20040724000392 |
| Provider Name | Deborah K Brantly Hunt |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1639198542 PECOS PAC ID: 2961465505 Enrollment ID: I20041105000024 |
| Provider Name | Wade L Hamil |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750311247 PECOS PAC ID: 7315846730 Enrollment ID: I20041118000983 |
| Provider Name | Mary P Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235167057 PECOS PAC ID: 3577504711 Enrollment ID: I20050608000269 |
| Provider Name | Melinda K Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922188705 PECOS PAC ID: 6204862998 Enrollment ID: I20050713001236 |
| Provider Name | Karon W Sharp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821293739 PECOS PAC ID: 3173548633 Enrollment ID: I20051107000352 |
| Provider Name | Keith W Russell |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1730270018 PECOS PAC ID: 1254353873 Enrollment ID: I20060106000624 |
| Provider Name | Jennifer Lyn Hamil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043329816 PECOS PAC ID: 9830196658 Enrollment ID: I20061108000437 |
| Provider Name | Elizabeth Pidcock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457385825 PECOS PAC ID: 0042219131 Enrollment ID: I20061219000417 |
| Provider Name | Sydney B Warren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174742779 PECOS PAC ID: 1456452424 Enrollment ID: I20070720000117 |
| Provider Name | Sue C Rollins |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1528104684 PECOS PAC ID: 1254418080 Enrollment ID: I20080404000001 |
| Provider Name | Cheryl E Hooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427140573 PECOS PAC ID: 8527147693 Enrollment ID: I20080501000193 |
| Provider Name | Richard Hartman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639110752 PECOS PAC ID: 4688692841 Enrollment ID: I20090121000656 |
| Provider Name | Margaret A Plummer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407976715 PECOS PAC ID: 5092870162 Enrollment ID: I20090224000747 |
| Provider Name | Martha W Hernandez |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811031016 PECOS PAC ID: 5294871182 Enrollment ID: I20091007000072 |
| Provider Name | Tazeen M Maududi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811100571 PECOS PAC ID: 2062550015 Enrollment ID: I20091111000375 |
| Provider Name | Diane J Vinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710922216 PECOS PAC ID: 0446443527 Enrollment ID: I20101021000422 |
| Provider Name | Rebecca L Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346375623 PECOS PAC ID: 0143403808 Enrollment ID: I20110318000105 |
| Provider Name | Leondra A Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992004626 PECOS PAC ID: 4284812967 Enrollment ID: I20110628000557 |
| Provider Name | Arun Joshua Mathew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821265133 PECOS PAC ID: 2860662558 Enrollment ID: I20110907001521 |
| Provider Name | Stephanie Susanne Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346282696 PECOS PAC ID: 8224209580 Enrollment ID: I20110916000026 |
| Provider Name | Angela Drumb Dunlevy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194980375 PECOS PAC ID: 2365618261 Enrollment ID: I20111227000165 |
| Provider Name | Kathleen Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427334408 PECOS PAC ID: 4587824669 Enrollment ID: I20120327000860 |
| Provider Name | Raymond G Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679743553 PECOS PAC ID: 0244485795 Enrollment ID: I20130306000578 |
| Provider Name | Gaybra L Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144562471 PECOS PAC ID: 9133367881 Enrollment ID: I20130607000565 |
| Provider Name | Deanna B Shackelford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477982569 PECOS PAC ID: 6901032655 Enrollment ID: I20131202001022 |
| Provider Name | John M Cummins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821288424 PECOS PAC ID: 1951524206 Enrollment ID: I20140514001083 |
| Provider Name | Pamela Lynn Bookout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801113642 PECOS PAC ID: 9436373933 Enrollment ID: I20140623001947 |
| Provider Name | Natalie Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730473828 PECOS PAC ID: 2860610029 Enrollment ID: I20140829001014 |
| Provider Name | Tiffany N Tottress |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023245800 PECOS PAC ID: 3375867898 Enrollment ID: I20150109001583 |
| Provider Name | Joseph Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265762884 PECOS PAC ID: 7012087380 Enrollment ID: I20150331000990 |
| Provider Name | Sandra Mace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700114295 PECOS PAC ID: 5496062093 Enrollment ID: I20150915001211 |
| Provider Name | Tu Bui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659712545 PECOS PAC ID: 8820307804 Enrollment ID: I20151013001707 |
| Provider Name | Carol L Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194119016 PECOS PAC ID: 2860792157 Enrollment ID: I20151118000157 |
| Provider Name | Diane L Smaling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679800817 PECOS PAC ID: 5698079507 Enrollment ID: I20160212000202 |
| Provider Name | Cynthia Sewell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518241769 PECOS PAC ID: 2365749298 Enrollment ID: I20160321001561 |
| Provider Name | Jessica A Stombaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487074787 PECOS PAC ID: 1759680366 Enrollment ID: I20160504000127 |
| Provider Name | Portia Goldsmith-nickelberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730490079 PECOS PAC ID: 4880983196 Enrollment ID: I20160510000647 |
| Provider Name | Sarah A Holien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750539326 PECOS PAC ID: 3678869369 Enrollment ID: I20160906002607 |
| Provider Name | Shylah Ridgway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952652133 PECOS PAC ID: 9830471150 Enrollment ID: I20170123000770 |
| Provider Name | Penelope C Holloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265986079 PECOS PAC ID: 6002192705 Enrollment ID: I20170412001079 |
| Provider Name | Huda Motiwala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760898324 PECOS PAC ID: 1153699772 Enrollment ID: I20170711000602 |
| Provider Name | Alexa M Smith Osborne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841451457 PECOS PAC ID: 1658644638 Enrollment ID: I20170913003612 |
| Provider Name | Natalie Kay Hearn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396054250 PECOS PAC ID: 7911263413 Enrollment ID: I20171116002226 |
| Provider Name | Amanda Quary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730552688 PECOS PAC ID: 3870851363 Enrollment ID: I20171209000004 |
| Provider Name | Karen Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679813349 PECOS PAC ID: 0941562748 Enrollment ID: I20180314001457 |
| Provider Name | Lisa Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124414727 PECOS PAC ID: 3274852363 Enrollment ID: I20180813002840 |
| Provider Name | Ken D Bond |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285042002 PECOS PAC ID: 1951651751 Enrollment ID: I20180828003850 |
| Provider Name | Ferdinande Djioto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558857078 PECOS PAC ID: 0648514760 Enrollment ID: I20181130000742 |
| Provider Name | Erin Lusk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083927123 PECOS PAC ID: 0941548259 Enrollment ID: I20190212002182 |
| Provider Name | Tausha Smith Mayberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770898991 PECOS PAC ID: 4789922022 Enrollment ID: I20190213000195 |
| Provider Name | Lori Kimberly Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235603606 PECOS PAC ID: 7911246608 Enrollment ID: I20190225000410 |
| Provider Name | Andrea L Skelton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265450886 PECOS PAC ID: 8820314776 Enrollment ID: I20190628001068 |
| Provider Name | Brandy Nicole Sanders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013567239 PECOS PAC ID: 2365773785 Enrollment ID: I20191015003223 |
| Provider Name | Rebecca L Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043868482 PECOS PAC ID: 4082040464 Enrollment ID: I20200203001453 |
| Provider Name | Sarah E. Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558608125 PECOS PAC ID: 3870901747 Enrollment ID: I20210413002042 |
| Provider Name | Brooksley Brown Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790208445 PECOS PAC ID: 7416357975 Enrollment ID: I20210621002560 |
| Provider Name | Shakendra M Leathers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699073379 PECOS PAC ID: 3678974631 Enrollment ID: I20210628002762 |
| Provider Name | Ashlee R Brown-lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700394434 PECOS PAC ID: 3274934039 Enrollment ID: I20210630002309 |
| Provider Name | Twyla Pumroy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396315677 PECOS PAC ID: 6204238520 Enrollment ID: I20210709000166 |
| Provider Name | Brooke Berthiaume |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114404084 PECOS PAC ID: 4789081258 Enrollment ID: I20210927000510 |
| Provider Name | Sharrell Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033868088 PECOS PAC ID: 9537547674 Enrollment ID: I20220602001023 |
| Provider Name | Kathryn Osinde |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013645829 PECOS PAC ID: 2668858853 Enrollment ID: I20220926000523 |
| Provider Name | Micah Jean Graves Barnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831322551 PECOS PAC ID: 1153707674 Enrollment ID: I20221005003501 |
| Provider Name | Teresa Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780237602 PECOS PAC ID: 8325402753 Enrollment ID: I20230918003007 |
| Provider Name | Diane Marie Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184811564 PECOS PAC ID: 3870948003 Enrollment ID: I20231009001704 |
| Provider Name | George August Kasper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174741359 PECOS PAC ID: 7012335433 Enrollment ID: I20240104001813 |
| Provider Name | Barbara Sweatt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174000632 PECOS PAC ID: 1052710191 Enrollment ID: I20240129000258 |
| Provider Name | Garth Coulson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942516661 PECOS PAC ID: 8325489396 Enrollment ID: I20240508004125 |
| Provider Name | Emily Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245089226 PECOS PAC ID: 1456793652 Enrollment ID: I20240520001677 |
| Provider Name | Alisha N White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447524566 PECOS PAC ID: 3678915246 Enrollment ID: I20240528003378 |
| Provider Name | Juanita Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427496660 PECOS PAC ID: 9032551577 Enrollment ID: I20240529002215 |
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