Jerri Lynn Mathis, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2241 Issued in OK

Practice address

1101 Honor Heights Dr
Jack C. Montgomery VA Medical Center
Muskogee, OK 74401-1302

Phone

(918) 577-3225

Fax

(918) 756-3876

NPI assigned

Apr 20, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1679717722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15795 OLD MORRIS HWY",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744478520",
            "telephone_number": "917-756-5405",
            "fax_number": "918-577-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HONOR HEIGHTS DR",
            "address_2": "JACK C. MONTGOMERY VA MEDICAL CENTER",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744011302",
            "telephone_number": "918-577-3225",
            "fax_number": "918-756-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "JERRI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "2241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Allan Mask, M.D.
• Fawna L Mason
• Amber Masters
• Leesa L Mathews, PT
• Susie Yvonne Mathews, L.P.N.
• Crystal Matlock, BS
• Matthew Hodgson DDS PLLC
• Paul P Matthews, D.O
• Madisynne Belle Mattioda
• Donald Jene Mayes Sr., SURGICAL TECH

• Clinical Social Worker in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.