Active NPI
Kelly Rose Whelan, LCSW
- Clinical Social Worker
- Oklahoma City, OK
National Provider Identifier
1629327358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 5054
- Practice address
- 416 NW 23Rd St
Oklahoma City, OK 73103 - Phone
- (405) 310-7463
- NPI assigned
- Sep 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 5054 | OK | Primary |
Addresses
Primary practice location
416 NW 23Rd St
Oklahoma City, OK 73103
Mailing address
616 NW 21St St Ste 105
Oklahoma City, OK 73103-1861
Phone (405) 310-7463
Other practice location 1
3400 Deskin Dr
Norman, OK 73069-8295
Phone (405) 701-8530 ext. 257
Other practice location 2
616 NW 21st St Ste 105
Oklahoma City, OK 73103-1861
Phone (405) 310-7463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200454620A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5054 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657065600000",
"number": "1629327358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 NW 21ST ST STE 105",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731031861",
"telephone_number": "405-310-7463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 NW 23RD ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73103",
"telephone_number": "405-310-7463"
}
],
"practiceLocations": [
{
"address_1": "3400 Deskin Dr",
"address_purpose": "LOCATION",
"city": "Norman",
"state": "OK",
"postal_code": "730698295",
"country_code": "US",
"telephone_number": "405-701-8530 x257",
"fax_number": "405-701-8531",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "616 NW 21st St Ste 105",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731031861",
"country_code": "US",
"telephone_number": "405-310-7463",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHELAN",
"first_name": "KELLY",
"middle_name": "ROSE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-10",
"last_updated": "2022-07-06",
"certification_date": "2022-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "5054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200454620A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.