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KATIE LYNN TOMJACK
NPI 1619604394
Social Worker in Pryor, OK

Active since August 03, 2022PECOS Enrolled
109 N FAIRLAND ST, PRYOR, OK 74361(918) 688-8327 Get Directions Write a Review

NPPES record last updated: August 3, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Katie Lynn Tomjack NPPES

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

KATIE LYNN TOMJACK (NPI 1619604394) is an individual social worker in Pryor, Oklahoma and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1619604394
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameKATIE LYNN TOMJACK
Location Address109 N FAIRLAND STPryor, OK 74361-4205
Mailing Address109 N Fairland StPryor, OK 74361-4205
Phone(918) 688-8327
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateAugust 3, 2022
NPPES CertifiedAugust 3, 2022
✔ NPI 1619604394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
109 N FAIRLAND ST, Pryor, OK 74361
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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)

Katie Lynn Tomjack is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062992969
PECOS Enrollment IDI20260218003805
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 Katie Tomjack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grand Lake Mental Health Center, Inc.
Same address
Mental Health (Including Community Mental Health Center)
109 N FAIRLAND ST
Pryor, OK 74361
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1871500900 (918) 825-1405

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.

KALI ROSE KERNS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
JACKIE ELAINE HORTON
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
WHITNEY JOANNA PHILLIPS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
BREANNA NICOLE COOK MHR, LPC-C
Counselor (Mental Health)
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1401
NICOLE BURNHAM LPN
Licensed Practical Nurse
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
STEPHANIE RENEE STACY
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841
CRYSTAL MICHELLE CUMMINS
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
KANDICE BRIANS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841

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 Katie Tomjack's NPI number?

The NPI number for Katie Tomjack is 1619604394. It was assigned to this individual provider in the NPPES registry on August 3, 2022.

Where is Katie Tomjack located?

Katie Tomjack practices at 109 N Fairland St, Pryor, OK 74361. The listed phone number is (918) 688-8327.

What is Katie Tomjack's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Katie Tomjack enrolled in Medicare?

Yes. Katie Tomjack is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katie Tomjack's services?

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

What insurance does Katie Tomjack accept?

Health plans from Oscar Insurance Company list Katie Tomjack 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 Katie Tomjack was last updated on August 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.