Active NPI
Kelsey Davis
- Physical Therapy Assistant
- Ardmore, OK
National Provider Identifier
1003492380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3003
- Practice address
- 1107 W Broadway St
Ardmore, OK 73401-2833 - Phone
- (580) 226-5566
- NPI assigned
- Mar 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3003 | OK | Primary |
Addresses
Primary practice location
1107 W Broadway St
Ardmore, OK 73401-2833
Mailing address
1405 4TH Ave NW # 296
Ardmore, OK 73401-2708
Phone (580) 226-5566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Rehab LLC | Physical Therapy Assistant | Current | Accepting new patients |
Locations
1107 W Broadway St
Ardmore, OK 73401
Phone (580) 226-5566
1405 4th Ave NW
Ardmore, OK 73401
Phone (580) 226-5566
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1003492380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 4TH AVE NW # 296",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734012708",
"telephone_number": "580-226-5566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 W BROADWAY ST",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734012833",
"telephone_number": "580-226-5566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KELSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-18",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "3003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ardmore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.