Individual provider Active NPI

Joseph D Petty

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1063856029
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5251 Issued in OK
Practice address
608 NW 9TH St
Suite 1100
Oklahoma City, OK 73102-1068
Phone
(405) 231-3000
Fax
(405) 231-3073
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 5251 OK Primary

Addresses

Primary practice location

608 NW 9TH St
Suite 1100
Oklahoma City, OK 73102-1068

Mailing address

608 NW 9TH St
Suite 1100
Oklahoma City, OK 73102-1068
Phone (405) 231-3000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170405000724 OK Practitioner - Clinical Social Worker 3779869755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Oklahoma College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

608 NW 9TH St
Suite 1100
Oklahoma City, OK 73102-1068
Phone (405) 231-3000

Hospital & facility affiliations

  • SSM Health St Anthony Hospital - Oklahoma City Hospital, Oklahoma City, OK, CCN 370037

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5251OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Apr 1, 2017 Accepting new patients
Saints Medical Group, LLC CurrentSince Apr 1, 2017 Accepting new patients
SSM Health Care of Oklahoma, Inc Current Accepting new patients

Locations

7106 Solutions Ctr
Chicago, IL 60677

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1063856029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 NW 9TH ST",
            "address_2": "SUITE 1100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021068",
            "telephone_number": "405-231-3000",
            "fax_number": "405-231-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 NW 9TH ST",
            "address_2": "SUITE 1100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021068",
            "telephone_number": "405-231-3000",
            "fax_number": "405-231-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JOSEPH",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "5251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.