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THEO EDWARDS
NPI 1194369892
Social Worker - Clinical in Kansas, OK

Active since November 05, 2019PECOS Enrolled
211 N HIGHWAY 59, KANSAS, OK 74347(918) 786-4434 Get Directions Write a Review

NPPES record last updated: November 28, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 28, 2025, Dec 19, 2019, Dec 9, 2019 and 1 more (4 updates tracked since 2019).

About Theo Edwards NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEO EDWARDS (NPI 1194369892) is an individual clinical provider in Kansas, Oklahoma, licensed in Oklahoma (20136) and active in the NPI registry since November 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194369892
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameTHEO EDWARDS
Location Address211 N HIGHWAY 59Kansas, OK 74347-7076
Mailing Address207 N. Hwy 59, Kansas OkKansas, OK 74347-0000 · (918) 786-4434
Phone(918) 786-4434
Sole ProprietorNo
Enumeration DateNovember 5, 2019
Last NPPES UpdateNovember 28, 20254 updates tracked since enumeration
NPPES CertifiedNovember 28, 2025
✔ NPI 1194369892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OK · 20136
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
211 N HIGHWAY 59, Kansas, OK 74347
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theo Edwards is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Theo Edwards reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Grand Lake Mental Health Center Inc.
8.0 mi
Mental Health (Including Community Mental Health Center)
191 N HIGHWAY 59
Kansas, OK 74347
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1295084531 (918) 308-5518
Compass Counseling Services PLLC
46 mi
Clinical
908 S LEE ST STE A
Fort Gibson, OK 74434
  • Reassigned Medicare billing, Oklahoma enrollment
  • 6 clinicians in this Medicare group
NPI 1346724747 (903) 715-2004

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74347 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $53.00 – $162.61
Typical copayment $0.00 (range $13.25 – $40.65)
Most-billed visit code NA
Established Patient
$66.48 typical visit price
range $16.68 – $132.40
Typical copayment $16.62 (range $4.17 – $33.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theo Edwards's NPI number?

The NPI number for Theo Edwards is 1194369892. It was assigned to this individual provider in the NPPES registry on November 5, 2019.

Where is Theo Edwards located?

Theo Edwards practices at 211 N Highway 59, Kansas, OK 74347. The listed phone number is (918) 786-4434.

What is Theo Edwards's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Theo Edwards enrolled in Medicare?

Yes. Theo Edwards is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Theo Edwards's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theo Edwards reassigns Medicare benefits to 2 organizations: Grand Lake Mental Health Center Inc. (Kansas, OK) and Compass Counseling Services PLLC (Fort Gibson, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theo Edwards's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theo Edwards accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and Oscar Insurance Company list Theo Edwards as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Theo Edwards was last updated on November 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.