Individual provider Active NPI

Carrie Rena Miller, LCSW

  • Clinical Social Worker
  • Moore, OK
National Provider Identifier
1922517374
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6065 Issued in OK
Practice address
9404 Buttonwood Ave
Moore, OK 73160-9137
Phone
(405) 237-3780
NPI assigned
Sep 28, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6214 FL
Clinical Social Worker 1041C0700X 6065 OK Primary

Addresses

Primary practice location

9404 Buttonwood Ave
Moore, OK 73160-9137

Mailing address

9404 Buttonwood Ave
Moore, OK 73160-9137
Phone (405) 496-0469

Other practice location 1

929 W Rulane Dr
Midwest City, OK 73110
Phone (405) 496-0469

Other identifiers 1

IdentifierTypeStateIssuer
200775820AMedicaidOK

Other names 1

  • Carrie Rena Krajewski Professional name

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
I20190530000555 OK Practitioner - Clinical Social Worker 7719963933 Reassigns benefits to 1 organization
Practice locations: Oklahoma City, OK

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

608 NW 9TH St
Suite 1100
Oklahoma City, OK 73102-1068
Phone (405) 231-3000

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW6214FLMDClinical Social Worker
6065OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Alternative Wellness Inc Clinical CurrentSince Sep 1, 2020 Accepting new patients
Saints Medical Group, LLC CurrentSince Nov 12, 2019 Accepting new patients
Saints Medical Group, LLC CurrentSince Nov 12, 2019 Accepting new patients
Ivan L Mazzorana Jr MD PA PastSince Nov 8, 2006 Accepting new patients
Samuel T Pinosky Mdpa Past Accepting new patients

Locations

608 NW 9th St
Ste 1100
Oklahoma City, OK 73102
Phone (405) 231-3000

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

Organizations & group practices 5

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922517374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9404 BUTTONWOOD AVE",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731609137",
            "telephone_number": "405-496-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9404 BUTTONWOOD AVE",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731609137",
            "telephone_number": "405-237-3780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 W Rulane Dr",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "73110",
            "country_code": "US",
            "telephone_number": "405-496-0469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CARRIE",
        "middle_name": "RENA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6214",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "6065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200775820A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "KRAJEWSKI",
            "middle_name": "RENA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.