Individual provider Active NPI

Timothy Dearhamer

  • Social Worker
  • Owasso, OK
National Provider Identifier
1316492382
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
9500 N 129TH East Ave Ste 200
Owasso, OK 74055-5376
Phone
(918) 858-4353
NPI assigned
Aug 19, 2016
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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 NU Primary

Addresses

Primary practice location

9500 N 129TH East Ave Ste 200
Owasso, OK 74055-5376

Mailing address

9500 N 129TH East Ave Ste 200
Owasso, OK 74055-5376
Phone (918) 858-4353

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
I20210324001017 OK Practitioner - Clinical Social Worker 3678980430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Tristesse Grief Center Inc Social Worker CurrentSince Mar 1, 2021 Accepting new patients
Timothylcsw LLC CurrentSince Oct 30, 2022 Accepting new patients
Family & Children's Services, Inc Past Accepting new patients
Anchored in Hope LLC Past Accepting new patients
Family & Children's Services, Inc Past Accepting new patients

Locations

2502 E 71st St
Tulsa, OK 74136
Phone (918) 587-1200

7914 E 106th St
Ste 205
Tulsa, OK 74133
Phone (918) 947-9560

Organizations & group practices 5

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": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1316492382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 N 129TH EAST AVE STE 200",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555376",
            "telephone_number": "918-858-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 N 129TH EAST AVE STE 200",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555376",
            "telephone_number": "918-858-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARHAMER",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.