JERRI L BOATNER – Clinical Social Worker, NPI 1669731568

JERRI L BOATNER is a healthcare provider. based in Earlsboro, Oklahoma. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 9212 (OK). The NPI Number for JERRI L BOATNER is 1669731568

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
JERRI L BOATNER
NPI
1669731568
Phone
(405) 997-8349
Address
35015 E 121
Enumeration Date
11 May 2012
Last Update Date
8 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5804365111
Graduation Year
2012 (14 years ago)
PAC ID
0547754632
Group Practice PAC ID
9931189685
Professional Enrollment ID
I20251216002675
Address ID
OK748681900SE2403XBLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:14State licenses:1Digital endpointsOther names

628 CLINICAL SOCIAL WORKER in OK

Provider Addresses for JERRI L BOATNER

  • 35015 E 121

    EARLSBORO, OK 748409064

    Phone: (405) 997-8349

    Type: Mailing

  • 300 E SEMINOLE AVE

    SEMINOLE, OK 748683934

    Phone: (405) 382-5438

    Type: Location

  • 615 W WASHINGTON ST

    TECUMSEH, OK 748732832

    Phone: (405) 432-3115

    Type: Mailing

  • 527 W 3rd St

    Konawa, OK 748491415

    Phone: (580) 925-2362

    Type: Location

  • 16820 STATE HIGHWAY 9 E

    EUFAULA, OK 744325220

    Phone: (918) 452-3335

    Fax: (918) 452-3939

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251216002675IClinical Social WorkerOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74840)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9931189685View full group profile
NameSpecialtyState
Physician AssistantOK
Nurse PractitionerOK
Nurse PractitionerOK
Family PracticeOK
Family Practice, Osteopathic Manipulative Medicine, Sports MedicineOK
Family PracticeOK
Nurse PractitionerOK
Physician AssistantOK
Endocrinology, Internal MedicineOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

How do payers reference JERRI L BOATNER?
For JERRI L BOATNER, use NPI 1669731568 as the unique 10-digit identifier.
Is JERRI L BOATNER still an active registrant?
JERRI L BOATNER carries an active NPI according to the public dataset.
What expertise is attributed to JERRI L BOATNER?
JERRI L BOATNER's specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with JERRI L BOATNER?
Directory geography for JERRI L BOATNER centers on Earlsboro, Oklahoma.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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