Individual provider Active NPI

Jace Scott, LMSW

  • Social Worker
  • Stillwater, OK
National Provider Identifier
1083382451
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
8055-P Issued in OK
Practice address
1624 Cimarron PLZ
Stillwater, OK 74075-3467
Phone
(405) 372-2202
Fax
(405) 372-2237
NPI assigned
Sep 1, 2021
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8055-P OK Primary

Addresses

Primary practice location

1624 Cimarron PLZ
Stillwater, OK 74075-3467

Mailing address

1624 Cimarron PLZ
Stillwater, OK 74075-3467
Phone (405) 372-2202

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
I20240916002207 OK Practitioner - Clinical Social Worker 4587105739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

111 S Treaty Rd
Miami, OK 74354-5327
Phone (918) 540-1511

998 E Knotts Ave
Stillwater, OK 74075-3023
Phone (405) 372-2202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8055-POKMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Sep 4, 2024 Accepting new patients
Grand Lake Mental Health Center Inc CurrentSince Sep 4, 2024 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

1624 Cimarron Plz
Stillwater, OK 74075
Phone (800) 722-3611

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1083382451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 CIMARRON PLZ",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740753467",
            "telephone_number": "405-372-2202",
            "fax_number": "405-372-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 CIMARRON PLZ",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740753467",
            "telephone_number": "405-372-2202",
            "fax_number": "405-372-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "JACE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "8055-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.