Individual provider Active NPI

Alexis Langston, OT

  • Occupational Therapist
  • Broken Arrow, OK
National Provider Identifier
1063923951
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2107 Issued in OK
Practice address
4800 W San Antonio St
Broken Arrow, OK 74012-6127
Phone
(918) 410-8740
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2107 OK Primary

Addresses

Primary practice location

4800 W San Antonio St
Broken Arrow, OK 74012-6127

Mailing address

4800 W San Antonio St Ste 103
Broken Arrow, OK 74012-6127
Phone (918) 410-8740

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
2107OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Peds Ok LLC Occupational Therapist Current Accepting new patients
Therapy Works Inc Occupational Therapist PastSince Jul 1, 2022 Accepting new patients

Locations

4800 W San Antonio St
Ste 103
Broken Arrow, OK 74012
Phone (918) 307-1320

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.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1063923951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W SAN ANTONIO ST STE 103",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126127",
            "telephone_number": "918-410-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 W SAN ANTONIO ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126127",
            "telephone_number": "918-410-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGSTON",
        "first_name": "ALEXIS",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "2107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.