Active NPI
Thomas James Zumwalt, L.C.S.W.
- Clinical Social Worker
- Broken Arrow, OK
National Provider Identifier
1841372265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2502
- Practice address
- 2329 W Twin Oaks St
Broken Arrow, OK 74011-1452 - Phone
- (918) 633-0551
- Fax
- (918) 449-8745
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2502 | OK | Primary |
Addresses
Primary practice location
2329 W Twin Oaks St
Broken Arrow, OK 74011-1452
Mailing address
2329 W Twin Oaks St
Broken Arrow, OK 74011-1452
Phone (918) 633-0551
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081119000883 | OK | Practitioner - Clinical Social Worker | 6305906447 | Practice locations: Broken Arrow, OK; Tulsa, OK |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- University of Oklahoma College of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1217 E College
Broken Arrow, OK 74012-4204
Phone (918) 258-3900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2502 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1841372265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2329 W TWIN OAKS ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740111452",
"telephone_number": "918-633-0551",
"fax_number": "918-449-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2329 W TWIN OAKS ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740111452",
"telephone_number": "918-633-0551",
"fax_number": "918-449-8745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUMWALT",
"first_name": "THOMAS",
"middle_name": "JAMES",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "2502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.