Individual provider Active NPI

Jennifer D Barnes

  • Clinical Social Worker
  • Vinita, OK
National Provider Identifier
1801319652
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5454 Issued in OK
Practice address
735 N Foreman St
Vinita, OK 74301-1422
Phone
(918) 256-9201
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5454 OK Primary

Addresses

Primary practice location

735 N Foreman St
Vinita, OK 74301-1422

Mailing address

PO Box 707001
Tulsa, OK 74170-7001
Phone (918) 502-8013

Other practice location 1

606 E 17th St
Baxter Springs, KS 66713-1730
Phone (918) 533-1450

Other names 1

  • Jennifer D Barnes Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210908000460 TX Practitioner - Clinical Social Worker 5991076606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Tribal Health SystemGroup PAC ID 7911893854, 20 clinicians

Practice addresses (Care Compare)

7600 S Hwy 69a
Miami, OK 74354-1016
Phone (918) 542-1655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5454OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Tribal Health System CurrentSince Aug 16, 2021 Accepting new patients

Locations

7600 S Highway 69A
Miami, OK 74354
Phone (918) 542-1655

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1801319652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707001",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741707001",
            "telephone_number": "918-502-8013",
            "fax_number": "918-502-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 N FOREMAN ST",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743011422",
            "telephone_number": "918-256-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 E 17th St",
            "address_purpose": "LOCATION",
            "city": "Baxter Springs",
            "state": "KS",
            "postal_code": "667131730",
            "country_code": "US",
            "telephone_number": "918-533-1450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "5454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BARNES",
            "middle_name": "D",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vinita, OK

Sources for this page

Verify at the official NPI Registry.