Individual provider Active NPI

Priscilla Anne Chiquin

  • Social Worker
  • Bartlesville, OK
National Provider Identifier
1225528409
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
8108 Issued in OK
Practice address
245 S. Madison
Bartlesville, OK 74006-3847
Phone
(918) 336-1463
Fax
(918) 331-9717
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 8108 OK Primary

Addresses

Primary practice location

245 S. Madison
Bartlesville, OK 74006-3847

Mailing address

245 S Madison Blvd
Bartlesville, OK 74006-2822
Phone (918) 851-1528

Other names 1

  • Priscilla Anne Crowder Former name

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
I20220304001598 OK Practitioner - Clinical Social Worker 6800280017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Family & Children'S Services, Inc Past Accepting new patients
Family & Children'S Services, Inc Past Accepting new patients

Locations

705 S Virginia Ave
Bartlesville, OK 74003
Phone (918) 231-0810

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

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

Organizations & group practices 4

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1225528409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S MADISON BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062822",
            "telephone_number": "918-851-1528",
            "fax_number": "918-337-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S. MADISON",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740063847",
            "telephone_number": "918-336-1463",
            "fax_number": "918-331-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIQUIN",
        "first_name": "PRISCILLA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "8108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "CROWDER",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

Verify at the official NPI Registry.