Individual provider Active NPI

Jessica Cothran, LCSW

  • Clinical Social Worker
  • Tulsa, OK
National Provider Identifier
1538337316
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4493 Issued in OK
Practice address
11740 E 21St St
Tulsa, OK 74129-1820
Phone
(918) 437-9494
Fax
(918) 231-0888
NPI assigned
Feb 14, 2008
Last updated
Jun 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X 4493 OK Primary

Addresses

Primary practice location

11740 E 21St St
Tulsa, OK 74129-1820

Mailing address

11740 E. 21St St
Tulsa, OK 74129
Phone (918) 437-9495

Other names 1

  • Jessica Cothran Professional name

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
I20140307000155 OK Practitioner - Clinical Social Worker 5294965513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Laureate Psychiatric Clinic and Hospital IncGroup PAC ID 3971599218, 78 clinicians

Practice addresses (Care Compare)

6655 S Yale Ave
Tulsa, OK 74136-3326
Phone (918) 481-4000

Merit-based Incentive Payment System (MIPS)

Final score
95.86 of 100Reported as group
Quality
85.15
Promoting interoperability
100
Improvement activities
40
Cost
78.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4493OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Children's Services, Inc Past Accepting new patients
Family & Children's Services, Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1538337316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 E. 21ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74129",
            "telephone_number": "918-437-9495",
            "fax_number": "918-234-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 E 21ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741291820",
            "telephone_number": "918-437-9494",
            "fax_number": "918-231-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTHRAN",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "COTHRAN",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.