Function Physical Therapy South LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

FUNCTION PHYSICAL THERAPY SOUTH LLC

Practice address

3012 W Hefner Rd
Village, OK 73120-5107

Phone

(405) 285-9659

Fax

(405) 285-8948

NPI assigned

Apr 14, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Seaton DONPI 1700847662

Title

Owner

Phone

(405) 285-9659

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Graham

  • Physical Therapist
  • Edmond, OK
  • NPI 1376273557
  Medicare reassignment NPD
• Seaton Q DO, PT

  • Physical Therapist
  • Edmond, OK
  • NPI 1700847662
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1043005572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 NW 178TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730124565",
            "telephone_number": "405-285-9659",
            "fax_number": "405-285-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 W HEFNER RD",
            "city": "VILLAGE",
            "state": "OK",
            "postal_code": "731205107",
            "telephone_number": "405-285-9659",
            "fax_number": "405-285-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTION PHYSICAL THERAPY SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "SEATON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-285-9659"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Raysanders
• Ashlee Vancuren
• Colette Kay Warkentin
• Yolanda Kaye Wright

• Physical Medicine & Rehabilitation Physician in Village, OK
• Providers in Village, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.