Individual provider Active NPI

Bobbette Jean Miller, DPT

  • Neurology Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1063697910
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
5560 Issued in OK
Practice address
820 NE 15TH St
Oklahoma City, OK 73104-4602
Phone
(405) 271-6242
Fax
(405) 271-2887
NPI assigned
Jan 9, 2008
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0011631 CO
Neurology Physical Therapist 2251N0400X 5560 OK Primary

Addresses

Primary practice location

820 NE 15TH St
Oklahoma City, OK 73104-4602

Mailing address

820 NE 15TH St
Oklahoma City, OK 73104-4602
Phone (405) 271-6242

Other practice location 1

2500 E Prospect Rd
Fort Collins, CO 80525-9718
Phone (970) 493-0112

Other names 1

  • Bobbette Jean Hickson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218000696 OK Practitioner - Physical Therapist in Private Practice 8628154754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

825 NE 13TH St
Oklahoma City, OK 73104-5005
Phone (405) 271-7410

Merit-based Incentive Payment System (MIPS)

Final score
81.73 of 100Reported as group
Quality
71.5
Promoting interoperability
100
Improvement activities
40
Cost
56.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0011631COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Medical Research Foundation CurrentSince Dec 6, 2018 Accepting new patients
Oklahoma Medical Research Foundation CurrentSince Dec 6, 2018 Accepting new patients
North Colorado Spine Center, LLC Past Accepting new patients

Locations

825 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-1500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1063697910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 NE 15TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044602",
            "telephone_number": "405-271-6242",
            "fax_number": "405-271-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 NE 15TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044602",
            "telephone_number": "405-271-6242",
            "fax_number": "405-271-2887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 E Prospect Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805259718",
            "country_code": "US",
            "telephone_number": "970-493-0112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BOBBETTE",
        "middle_name": "JEAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0011631",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "OK",
            "license": "5560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBETTE",
            "last_name": "HICKSON",
            "middle_name": "JEAN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.