Active NPI
Samer Imad Zantout, PT
- Physical Therapist
- Edmond, OK
National Provider Identifier
1023038577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3789
- Practice address
- 13801 N Bryant Ave
Suite 400
Edmond, OK 73013-6440 - Phone
- (405) 286-6080
- Fax
- (866) 594-7004
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- 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 Therapist | 225100000X | 3789 | OK | Primary |
Addresses
Primary practice location
13801 N Bryant Ave
Suite 400
Edmond, OK 73013-6440
Mailing address
13801 N Bryant Ave
Suite 400
Edmond, OK 73013-6440
Phone (405) 286-6080
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3789 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470787200000",
"number": "1023038577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13801 N BRYANT AVE",
"address_2": "SUITE 400",
"city": "EDMOND",
"state": "OK",
"postal_code": "730136440",
"telephone_number": "405-286-6080",
"fax_number": "866-594-7004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13801 N BRYANT AVE",
"address_2": "SUITE 400",
"city": "EDMOND",
"state": "OK",
"postal_code": "730136440",
"telephone_number": "405-286-6080",
"fax_number": "866-594-7004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZANTOUT",
"first_name": "SAMER",
"middle_name": "IMAD",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2016-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "3789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.