Active NPI
Dawn Ballew
- Clinical Social Worker
- Tahlequah, OK
National Provider Identifier
1386017374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4951
- Practice address
- 315 N College Ave
Tahlequah, OK 74464-2703 - Phone
- (918) 453-1171
- NPI assigned
- Nov 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4951 | OK | Primary |
Addresses
Primary practice location
315 N College Ave
Tahlequah, OK 74464-2703
Mailing address
19216 W Pettit Bay Rd
Park Hill, OK 74451-3010
Phone (918) 453-1171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200606480 A | Medicaid | OK |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151117002975 | OK | Practitioner - Clinical Social Worker | 6305156696 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1386017374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19216 W PETTIT BAY RD",
"city": "PARK HILL",
"state": "OK",
"postal_code": "744513010",
"telephone_number": "918-453-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 N COLLEGE AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744642703",
"telephone_number": "918-453-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLEW",
"first_name": "DAWN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-12",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "4951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200606480 A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.