Jordan Benson
Individual provider Active NPI Physical Therapist · Shawnee, OK
NPI 1043025836 · NPPES record last updated Feb 10, 2025
Key facts
- NPI
- 1043025836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 6667 (OK)
- Practice address
- 781 Grand Casino Blvd
Shawnee, OK 74804-1005 - Phone
- (405) 695-6004
- NPI assigned
- Feb 10, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6667 | OK | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6667 | OK | Yes |
Addresses
Primary practice location
781 Grand Casino Blvd
Shawnee, OK 74804-1005
Mailing address
16212 Juliet Dr
Edmond, OK 73013-9235
Other providers in Shawnee, OK
- Rachel Beiermann
- Lyric Bell
- Michael Bennett
- Richard Dean Bennett
- Taylor Faith Bennett
- Annette Bentley
- Bethel Public Schools
- Caitlin Dawn Bilyeu
- Bio-Medical Applications of Oklahoma, Inc.
- Ethan Birdwell
All providers in Shawnee, 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 Feb 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.