Individual provider Active NPI

Phillip Jay Thomson, LCSW

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1982184792
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21109 Issued in OK
Practice address
5208 W Reno Ave
Oklahoma City, OK 73127-6344
Phone
(405) 948-4900
Fax
(405) 948-4933
NPI assigned
Aug 21, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 21109 OK Primary
Social Worker 104100000X

Addresses

Primary practice location

5208 W Reno Ave
Oklahoma City, OK 73127-6344

Mailing address

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900

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
I20240929000100 TX Practitioner - Clinical Social Worker 0941731145 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oklahoma American Indian Health Council, Inc. CurrentSince Aug 7, 2024 Accepting new patients

Locations

309 S Ann Arbor Ave
Oklahoma City, OK 73128
Phone (405) 948-4900

5208 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900

4913 W Reno Ave
Oklahoma City, OK 73127
Phone (405) 948-4900

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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1982184792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4913 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276339",
            "telephone_number": "405-948-4900",
            "fax_number": "405-948-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 W RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731276344",
            "telephone_number": "405-948-4900",
            "fax_number": "405-948-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "PHILLIP",
        "middle_name": "JAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "21109",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.