Individual provider Active NPI

Dustin D Rhoades

  • Physical Therapy Assistant
  • Duncan, OK
National Provider Identifier
1053776641
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2368 Issued in OK
Practice address
1407 N Whisenant Dr
Duncan, OK 73533-1650
Phone
(580) 251-8100
NPI assigned
Dec 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2368 OK Primary

Addresses

Primary practice location

1407 N Whisenant Dr
Duncan, OK 73533-1650

Mailing address

434 NW Greenmeadow Dr
Lawton, OK 73507-2220
Phone (580) 512-8469

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2368OKMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1053776641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 NW GREENMEADOW DR",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735072220",
            "telephone_number": "580-512-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N WHISENANT DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331650",
            "telephone_number": "580-251-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHOADES",
        "first_name": "DUSTIN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.