Misty M Case

Individual provider Active NPI Case Manager/Care Coordinator · Grove, OK

NPI 1497498562 · NPPES record last updated Apr 18, 2022

Key facts

NPI
1497498562
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1115 Har-Ber Road
Grove, OK 74344
Phone
(918) 786-4434
NPI assigned
Apr 18, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

114 W Delaware Ave
Nowata, OK 74048-2601

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260430000611 OK Practitioner - Mental Health Counselor 9032686795 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. Past
since Apr 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1115 Har-Ber Road
Grove, OK 74344

Mailing address

1115 Har-Ber Road
Grove, OK 74344

Other providers in Grove, OK

All providers in Grove, OK · Case Manager/Care Coordinator in Oklahoma

Sources for this page

Verify at the official NPI Registry.