Active NPI
Robe Lew Mourer, LCSW
- Clinical Social Worker
- Tipton, OK
National Provider Identifier
1124127725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3167
- Practice address
- 624 E Baseline Rd
Tipton, OK 73570 - Phone
- (918) 574-1169
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3167 | OK | Primary |
Addresses
Primary practice location
624 E Baseline Rd
Tipton, OK 73570
Mailing address
624 E Baseline Rd
Tipton, OK 73570-6001
Phone (918) 574-1169
Other practice location 1
4045 NW 64th St
Suite 520
Oklahoma City, OK 73116-1684
Phone (918) 574-1169
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124127725 | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3167 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531785600000",
"number": "1124127725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 E BASELINE RD",
"city": "TIPTON",
"state": "OK",
"postal_code": "735706001",
"telephone_number": "918-574-1169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 E BASELINE RD",
"city": "TIPTON",
"state": "OK",
"postal_code": "73570",
"telephone_number": "918-574-1169"
}
],
"practiceLocations": [
{
"address_1": "4045 NW 64th St",
"address_2": "Suite 520",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731161684",
"country_code": "US",
"telephone_number": "918-574-1169",
"fax_number": "405-842-4911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOURER",
"first_name": "ROBE",
"middle_name": "LEW",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2018-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "3167",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124127725",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tipton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.