Individual provider Active NPI

Evelyn Amy Cotten

  • Social Worker
  • Vinita, OK
National Provider Identifier
1821563610
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
405 E Excelsior Ave
Vinita, OK 74301-4226
Phone
(918) 256-6476
Fax
(918) 256-3628
NPI assigned
Oct 8, 2018
Last updated
Oct 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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 NU Primary

Addresses

Primary practice location

405 E Excelsior Ave
Vinita, OK 74301-4226

Mailing address

405 E Excelsior Ave
Vinita, OK 74301-4226
Phone (918) 256-6476

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
I20230905000390 OK Practitioner - Clinical Social Worker 3678936929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Jul 22, 2023 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients
Grand Lake Mental Health Center Inc CurrentSince Jul 22, 2023 Accepting new patients

Locations

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

405 E Excelsior Ave
Vinita, OK 74301
Phone (918) 256-6476

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, 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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1821563610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E EXCELSIOR AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014226",
            "telephone_number": "918-256-6476",
            "fax_number": "918-256-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E EXCELSIOR AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014226",
            "telephone_number": "918-256-6476",
            "fax_number": "918-256-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTEN",
        "first_name": "EVELYN",
        "middle_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinita, OK

Sources for this page

Verify at the official NPI Registry.