Individual provider Active NPI

Octavia Bartmess

  • Clinical Social Worker
  • Saint Charles, MO
National Provider Identifier
1548054000
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2025043136 Issued in MO
Practice address
2451 Executive Dr Ste 205
Saint Charles, MO 63303-5606
Phone
(385) 533-9590
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2025043136 MO Primary
Clinical Social Worker 1041C0700X 14250927-3502 UT

Addresses

Primary practice location

2451 Executive Dr Ste 205
Saint Charles, MO 63303-5606

Mailing address

8977 S 1300 W # 2029
West Jordan, UT 84088-9274

Other practice location 1

40 Tonto Apache Reservation
Payson, AZ 85541-5556
Phone (928) 472-3906

Other practice location 2

1204 W South Jordan Pkwy Ste C
South Jordan, UT 84095-4612
Phone (385) 503-8398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260127002411 AZ Practitioner - Clinical Social Worker 1951888445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13515 Sundance Scape
San Antonio, TX 78245-3444

40 Tonto Apache Reservation
Payson, AZ 85541-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025043136MOMDClinical Social Worker
14250927-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tonto Apache Healthcare LLC CurrentSince Oct 16, 2025 Accepting new patients

Locations

30 Tonto Apache Reservation
Payson, AZ 85541
Phone (928) 474-5000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1548054000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8977 S 1300 W # 2029",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 EXECUTIVE DR STE 205",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035606",
            "telephone_number": "385-533-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 TONTO APACHE RESERVATION",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855415556",
            "country_code": "US",
            "telephone_number": "928-472-3906",
            "fax_number": "928-474-3101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1204 W South Jordan Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "South Jordan",
            "state": "UT",
            "postal_code": "840954612",
            "country_code": "US",
            "telephone_number": "385-503-8398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTMESS",
        "first_name": "OCTAVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2025043136",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "14250927-3502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.