Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derra Bishop

Individual provider Case Manager/Care Coordinator · NPI 1548829054

Derra Bishop is a Mental Health Counselor in Ponca City, Oklahoma. Qualified in 2021, 5 years ago. Works from 3 locations.

Years since qualifying
5
In the registry since
2019
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Practice location Address checks out

110 N 4th St
Ponca City, OK 74601
Phone: (580) 749-5056
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1613 Bradbary Ln, Ponca City, OK 74601-2514 — (580) 628-1551
  • 1613 Bradbary Ln, Ponca City, OK 74601-2514 — (580) 628-1551

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1548829054
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 8, 2019
Last updated in NPPESJuly 8, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Ponca City