Pamela Sue Kerkstra, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3453 Issued in OK

Practice address

2525 3Rd Ave NE
Ardmore, OK 73401-8122

Phone

(580) 223-2142

NPI assigned

Oct 3, 2008

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

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Shepherd Community Clinic, Inc.Group PAC ID 4284936337, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pam.kerkstra.1@21725.direct.athenahealth.com

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.

• Good Shepherd Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ardmore, OK
  • NPI 1285010413
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1821249293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 3RD AVE NE",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734018122",
            "telephone_number": "580-223-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 3RD AVE NE",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734018122",
            "telephone_number": "580-223-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERKSTRA",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Kelsey
• Emily Kem
• Angela Y Kemp-Miller, LMFT
• Charley Kemp
• Nikayla Estelle Virginia Kenoly
• Vicki Kerley, CADC
• Lillian Kessel
• Tufal Khan, M.D.
• Seonju Kim
• Pamela Lynn Kimbrough, MD

• Clinical Social Worker in Ardmore, OK
• Providers in Ardmore, 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 Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.