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DERRA BISHOP
NPI 1548829054
Case Manager/Care Coordinator in Ponca City, OK

Active since June 08, 2019PECOS Enrolled
110 N 4TH ST, PONCA CITY, OK 74601(580) 749-5056 Get Directions Write a Review

NPPES record last updated: July 8, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 8, 2019, Jun 8, 2019 (2 updates tracked since 2019).

About Derra Bishop NPPES

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

DERRA BISHOP (NPI 1548829054) is an individual case manager/care coordinator provider in Ponca City, Oklahoma and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Ponca City, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1548829054
Entity TypeIndividualFemale
Primary Taxonomy171M00000X
Provider Legal NameDERRA BISHOP
Location Address110 N 4TH STPonca City, OK 74601
Mailing Address110 N 4th StPonca City, OK 74601-4527 · (580) 749-5056
Phone(580) 749-5056
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJune 8, 2019
Last NPPES UpdateJuly 8, 20192 updates tracked since enumeration
✔ NPI 1548829054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
110 N 4TH ST, Ponca City, OK 74601
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Secondary Practice Location 1

Location 11613 Bradbary LnPonca City, OK 74601-2514 · Phone (580) 628-1551

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)

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

PECOS PAC ID345722666
PECOS Enrollment IDI20260305002648
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 Reassignment

Medicare enrollment records show Derra Bishop reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grand Lake Mental Health Center Inc
6.5 mi
Community/Behavioral Health
407 W SOUTH AVE
Ponca City, OK 74601
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1356981138 (580) 749-5056

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN KIRK LPC
Counselor (Mental Health)
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 749-5056
MRS. TERESA ANN JONES
Case Manager/Care Coordinator
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 762-3217
JOHN WENSLER RSS
Peer Specialist
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 749-5056
CARRIE ELIZABETH INGRAM
Case Manager/Care Coordinator
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 749-5056
DANIEL JAMES SHAFFER
Case Manager/Care Coordinator
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 749-5056
SHALEEN FAY COLTON
Peer Specialist
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 749-5056
TAMMY DIAN BURKE
Registered Nurse
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (580) 749-5056
KILEY ELIZABETH SIMON
Case Manager/Care Coordinator
110 N 4TH ST
PONCA CITY, OK 74601
Kay County (405) 372-2202

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 Derra Bishop's NPI number?

The NPI number for Derra Bishop is 1548829054. It was assigned to this individual provider in the NPPES registry on June 8, 2019.

Where is Derra Bishop located?

Derra Bishop practices at 110 N 4th St, Ponca City, OK 74601. The listed phone number is (580) 749-5056.

What is Derra Bishop's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Is Derra Bishop enrolled in Medicare?

Yes. Derra Bishop is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Derra Bishop's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derra Bishop reassigns Medicare benefits to Grand Lake Mental Health Center Inc (Ponca City, OK). The 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 Derra Bishop's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derra Bishop accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and Oscar Insurance Company list Derra Bishop 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 Derra Bishop was last updated on July 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.