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
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

110 N 4th St
Ponca City, OK 74601
Phone: (580) 749-5056
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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
Mailing address110 N 4th St, Ponca City, OK 74601-4527

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