Individual provider Active NPI

Clark Irvin Grothe, LCSW

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1225478951
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4436 NW 50TH St
Oklahoma City, OK 73112-2212
Phone
(405) 858-2826
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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 NU Primary

Addresses

Primary practice location

4436 NW 50TH St
Oklahoma City, OK 73112-2212

Mailing address

4436 NW 50TH St
Oklahoma City, OK 73112-2212
Phone (405) 858-2826

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
I20181017003284 OK Practitioner - Clinical Social Worker 2769734805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1505 E Main St
Stigler, OK 74462-2914
Phone (800) 640-9741

2013 E Meadow LN
Stigler, OK 74462-2708

PO Box
Suite 179
Stigler, OK 74462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stigler Health and Wellness Center Inc CurrentSince Sep 17, 2018 Accepting new patients
Stigler Health and Wellness Center Inc PastSince Feb 13, 2022 Accepting new patients

Locations

111 W Forrest Ave
Eufaula, OK 74432
Phone (800) 640-9741

1120 Tarby Rd
Poteau, OK 74953
Phone (800) 640-9741

1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741

Organizations & group practices 2

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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1225478951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4436 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122212",
            "telephone_number": "405-858-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4436 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122212",
            "telephone_number": "405-858-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTHE",
        "first_name": "CLARK",
        "middle_name": "IRVIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.