Individual provider Active NPI

Caitlin Sue Smith

  • Case Manager/Care Coordinator
  • Miami, OK
National Provider Identifier
1639719578
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
111 S Treaty Rd
Miami, OK 74354-5327
Phone
(918) 540-1511
Fax
(918) 542-7374
NPI assigned
Jan 8, 2020
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

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

Addresses

Primary practice location

111 S Treaty Rd
Miami, OK 74354-5327

Mailing address

111 S Treaty Rd
Miami, OK 74354-5327
Phone (918) 540-1511

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
I20250122002369 OK Practitioner - Clinical Social Worker 0042749962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center Inc CurrentSince Jan 17, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Jan 17, 2025 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

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": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1639719578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S TREATY RD",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743545327",
            "telephone_number": "918-540-1511",
            "fax_number": "918-542-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S TREATY RD",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743545327",
            "telephone_number": "918-540-1511",
            "fax_number": "918-542-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAITLIN",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.