Individual provider Active NPI

Portia Goldsmith-Nickelberry

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1730490079
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4889 Issued in OK
Practice address
2309 NW 118TH St
Oklahoma City, OK 73120-7425
Phone
(405) 370-8964
NPI assigned
Jul 1, 2010
Last updated
Jul 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4889 OK Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

2309 NW 118TH St
Oklahoma City, OK 73120-7425

Mailing address

2309 NW 118TH St
Oklahoma City, OK 73120-7425
Phone (405) 608-4198

Other practice location 1

906 NW 92ND St
Oklahoma City, OK 73114-2704
Phone (405) 848-2171

Other practice location 2

2130 SW 59th St
Oklahoma City, OK 73119-7025
Phone (405) 303-7555

Other practice location 3

1918 NE 23rd St
Oklahoma City, OK 73111-3328
Phone (405) 453-8000

Other practice location 4

7521 SE 15th St
Midwest City, OK 73110-5425
Phone (405) 453-8004

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
I20160510000647 OK Practitioner - Clinical Social Worker 4880983196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2309 NW 118TH St
Oklahoma City, OK 73120-7425
Phone (405) 370-8964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1730490079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 NW 118TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731207425",
            "telephone_number": "405-608-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 NW 118TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731207425",
            "telephone_number": "405-370-8964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 NW 92ND ST",
            "address_purpose": "LOCATION",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731142704",
            "country_code": "US",
            "telephone_number": "405-848-2171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2130 SW 59th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731197025",
            "country_code": "US",
            "telephone_number": "405-303-7555",
            "fax_number": "405-561-5615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1918 NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731113328",
            "country_code": "US",
            "telephone_number": "405-453-8000",
            "fax_number": "405-561-4984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7521 SE 15th St",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731105425",
            "country_code": "US",
            "telephone_number": "405-453-8004",
            "fax_number": "405-561-4857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDSMITH-NICKELBERRY",
        "first_name": "PORTIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4889",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.