Individual provider Active NPI

Amy Smith-Ellis, BHCMII CPRSS BHWC

  • Case Manager/Care Coordinator
  • Norman, OK
National Provider Identifier
1699495267
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
319533 Issued in OK
Practice address
1120 E Main St
Norman, OK 73071-5300
Phone
(405) 573-3812
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Case Manager/Care Coordinator 171M00000X 319533 OK Primary
Health & Wellness Coach 171400000X 7470 OK
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1120 E Main St
Norman, OK 73071-5300

Mailing address

1120 E Main St
Norman, OK 73071-5300
Phone (405) 573-3812

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
319533OKMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1699495267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715300",
            "telephone_number": "405-573-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730715300",
            "telephone_number": "405-573-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-ELLIS",
        "first_name": "AMY",
        "credential": "BHCMII CPRSS BHWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": "319533",
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "OK",
            "license": "7470",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.