Individual provider Active NPI

Shavonne M Francis, LMSW U/SUPERVISION

  • Social Worker
  • Miami, OK
National Provider Identifier
1760050249
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
7974 Issued in OK
Practice address
111 S Treaty Rd
Miami, OK 74354-5327
Phone
(918) 540-1511
NPI assigned
Jun 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7974 OK 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
I20231130001998 OK Practitioner - Clinical Social Worker 8426406448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7974OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center Inc. CurrentSince Oct 10, 2023 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Oct 10, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1760050249",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCIS",
        "first_name": "SHAVONNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LMSW U/SUPERVISION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "7974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.