Melissa Estelle McBride, PT

Individual provider Active NPI Physical Therapist · Mannford, OK

NPI 1053529552 · NPPES record last updated Jan 22, 2024

Key facts

NPI
1053529552
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
3802 (OK)
Practice address
112 Evans Avenue
Mannford, OK 74044
Phone
(918) 865-7020
Fax
(918) 865-7039
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Pathways Preferred of Tennessee LLC (194 clinicians)

Practice addresses (Care Compare)

7300 E 121St PL S
Bixby, OK 74008-5875
Phone (888) 531-2204

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220810000272 OK Practitioner - Physical Therapist in Private Practice 4880077783 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3802OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Results Therapy Services LLC Physical Therapist Current
since Jul 7, 2022
Accepting new patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist Current
since Jun 1, 2025
Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3802 OK Yes

Addresses

Primary practice location

112 Evans Avenue
Mannford, OK 74044

Mailing address

PO Box 361
Mannford, OK 74044-0361
Phone (918) 862-7020

Other providers in Mannford, OK

All providers in Mannford, OK · Physical Therapist in Oklahoma

Sources for this page

Verify at the official NPI Registry.