Individual provider Active NPI

Kimberly Thompson, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Muskogee, OK
National Provider Identifier
1245615129
Registry record updated Sep 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
619 N Main St
Muskogee, OK 74401-4431
Phone
(918) 682-8407
NPI assigned
Jul 21, 2015
Last updated
Sep 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Clinical Social Worker 1041C0700X 6315 OK

Addresses

Primary practice location

619 N Main St
Muskogee, OK 74401-4431

Mailing address

619 N Main St
Muskogee, OK 74401-4431
Phone (918) 682-8407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191015000557 OK Practitioner - Clinical Social Worker 9739410218 Reassigns benefits to 1 organization
I20210419000932 TX Practitioner - Clinical Social Worker 9739410218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 1, 2021 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Aug 10, 2019 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Aug 10, 2019 Accepting new patients

Locations

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

1125 E Cleveland Ave
Sapulpa, OK 74066
Phone (918) 224-9310

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1467
Tulsa, OK 74182

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, 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": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1245615129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014431",
            "telephone_number": "918-682-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014431",
            "telephone_number": "918-682-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "6315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.