Jessica Marie Ortiz

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1392 Issued in OK

Practice address

1313 W Ferguson Ave
Blackwell, OK 74631-5604

Phone

(580) 789-3100

NPI assigned

Dec 18, 2019

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Female

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, OK
  • NPI 1497762520
  Medicare reassignment
• Grand Lake Mental Health Center, Inc.

  dba Grand Mental Health

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD
• Grand Lake Mental Health Center, Inc.

  dba GRAND Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cleveland, OK
  • NPI 1609434257
  NPD

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1508404740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 W FERGUSON AVE",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746315604",
            "telephone_number": "580-789-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W FERGUSON AVE",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746315604",
            "telephone_number": "580-789-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "1392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noda PLLC
• Northern Oklahoma Dental Associates PLLC
• Northern Therapy & Rehabilitation, Inc
• Oklahoma City Vamc
• Oklahoma Emergency Physician Partners PLLC
• Hali Nicole Owings
• Lacee Pierson
• Jennifer Elisabeth Prater, DPH
• Robert P London DDS Corp
• Bree Nicole Rowe

• Counselor in Blackwell, OK
• Providers in Blackwell, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.