Individual provider Active NPI

Oteasa R Gist, LCSW

  • Clinical Social Worker
  • Claremore, OK
National Provider Identifier
1174142194
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8795 Issued in OK
Practice address
3100 Medical Pkwy
Claremore, OK 74017-1088
Phone
(918) 382-7300
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8795 OK Primary

Addresses

Primary practice location

3100 Medical Pkwy
Claremore, OK 74017-1088

Mailing address

904 W Kenosha St Ste 2
Broken Arrow, OK 74012-8917
Phone (918) 269-5058

Other practice location 1

904 W Kenosha St Ste 2
Broken Arrow, OK 74012-8917
Phone (918) 269-5058

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
I20230816000688 OK Practitioner - Clinical Social Worker 1153783675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Pathways Unlimited IncGroup PAC ID 6608776349, 21 clinicians

Practice addresses (Care Compare)

4045 NW 64TH St
Suite 520
Oklahoma City, OK 73116-8608
Phone (405) 842-4911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Pathways Unlimited Inc CurrentSince Jul 7, 2023 Accepting new patients

Locations

4045 NW 64th St
Ste 520
Oklahoma City, OK 73116
Phone (405) 685-4791

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1174142194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W KENOSHA ST STE 2",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128917",
            "telephone_number": "918-269-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MEDICAL PKWY",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740171088",
            "telephone_number": "918-382-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 W Kenosha St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740128917",
            "country_code": "US",
            "telephone_number": "918-269-5058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIST",
        "first_name": "OTEASA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "8795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.