Jeremy Paul Elledge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4410 Issued in OK

Practice address

1120 E Main St
Norman, OK 73071-5300

Phone

(405) 360-5100

Fax

(405) 364-3209

NPI assigned

Feb 6, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• State of Oklahoma

  dba Central Oklahoma Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norman, OK
  • NPI 1588755532
  Medicare reassignment NPD
• State of Oklahoma

  • Skilled Nursing Facility
  • Talihina, OK
  • NPI 1154589430
  NPD
• State of Oklahoma

  dba Central Oklahoma Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norman, OK
  • NPI 1427217470
  NPD
• Sundance Counseling & Mental Health

  • Psychiatry Physician
  • Norman, OK
  • NPI 1871601559
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1457539975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 MEMPHIS DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730712013",
            "telephone_number": "405-642-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715300",
            "telephone_number": "405-360-5100",
            "fax_number": "405-364-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole M Eliason, L.C.S.W.
• Kathrin Andrews Eliot, R.D.
• Elise R Wiesner MD PC
• Merrie Michal Elisens, PH.D.
• Gael Elizondo, RBT
• Elliott Medical Services, Inc
• Amanda Elliott
• Bobby L Elliott, DO
• Hannah Elliott
• Rebecca Elliott

• Clinical Social Worker in Norman, OK
• Providers in Norman, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.

Verify at the official NPI Registry.