Active NPI
Dwight David Kinzer, MSW
- Clinical Social Worker
- Tulsa, OK
National Provider Identifier
1679670152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0354
- Practice address
- 9322 E 41St
Tulsa, OK 74145 - Phone
- (918) 764-7212
- Fax
- (918) 764-7208
- NPI assigned
- Sep 19, 2006
- Sex
- Male
- 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 | 0354 | OK | Primary |
Addresses
Primary practice location
9322 E 41St
Tulsa, OK 74145
Mailing address
1615 S. Gary Ave
Tulsa, OK 74104-5216
Phone (918) 744-6087
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0354 | Other | OK | CLINICAL SOCIAL WORKER |
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 |
|---|---|---|---|
| 0354 | OK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679670152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 S. GARY AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741045216",
"telephone_number": "918-744-6087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9322 E 41ST",
"city": "TULSA",
"state": "OK",
"postal_code": "74145",
"telephone_number": "918-764-7212",
"fax_number": "918-764-7208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINZER",
"first_name": "DWIGHT",
"middle_name": "DAVID",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "0354",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL SOCIAL WORKER",
"identifier": "0354",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.