Elite Therapy Groups of Texas County, L.L.C
Organization Active NPI Physical Therapist · Guymon, OK
NPI 1003869975 · NPPES record last updated Dec 2, 2021
Key facts
- NPI
- 1003869975
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- ELITE THERAPY GROUPS OF TEXAS COUNTY, L.L.C
- Practice address
- 1311 N Main St
Guymon, OK 73942-3303 - Phone
- (580) 338-4676
- Fax
- (580) 338-4686
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kristi L. Cooper-Johnson, RPT
- Title
- Owner
- Phone
- (580) 338-4676
Practitioners 3
-
Eric G Johnson, RPT
-
Alejandria Seraiah Kasparie, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060719000222 | OK | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2860405792 |
Receives reassigned benefits from 1 practitioner Practice locations: Guymon, OK |
National Provider Directory
Locations
1311 N Main St
Guymon, OK 73942
Phone (580) 338-4676
1301 N Main St
Guymon, OK 73942
Phone (580) 338-4676
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
1311 N Main St
Guymon, OK 73942-3303
Mailing address
1311 N Main St
Guymon, OK 73942-3303
Phone (580) 338-4676
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 900522375 | Other | OK | MEDICARE PTAN |
Other providers in Guymon, OK
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- Carah Jean Dupper
- Amy Duren
- Eaglemed, LLC
- Jason Wayne Eidson
- Emmanuel L Barias, MD LLC
- Anahi Rosaura Espinoza
- Adam Lance Fick
- Megan Marie Furnish
- Pamela Janeell Gallegos
All providers in Guymon, OK · Physical Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.