Individual provider Active NPI

Jessica Anne Stevens

  • Social Worker
  • Oklahoma City, OK
National Provider Identifier
1356846133
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6920 Issued in OK
Practice address
2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone
(405) 219-0411
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X 6920 OK Primary

Addresses

Primary practice location

2617 General Pershing Blvd
Oklahoma City, OK 73107-6437

Mailing address

2617 General Pershing Blvd
Oklahoma City, OK 73107-6437
Phone (405) 858-1700

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
I20231004003991 OK Practitioner - Clinical Social Worker 8123473568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6920OKMDSocial Worker
8661OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Oklahoma County Mental Health Center CurrentSince Jun 21, 2023 Accepting new patients

Locations

2617 General Pershing Blvd
Oklahoma City, OK 73107
Phone (405) 858-1700

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1356846133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 GENERAL PERSHING BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076437",
            "telephone_number": "405-858-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 GENERAL PERSHING BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076437",
            "telephone_number": "405-219-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "6920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.