Individual provider Active NPI

Shoma Moriasha Gayah, PT

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1063957066
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5151 Issued in OK
Practice address
1634 Sw122Nd St
Oklahoma City, OK 73170
Phone
(405) 692-2366
Fax
(405) 692-2337
NPI assigned
Dec 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5151 OK Primary

Addresses

Primary practice location

1634 Sw122Nd St
Oklahoma City, OK 73170

Mailing address

17301 Clove Hill PL
Edmond, OK 73012-9705
Phone (630) 347-2552

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc PastSince Dec 19, 2016 Accepting new patients

Organizations & group practices 1

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": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1063957066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17301 CLOVE HILL PL",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129705",
            "telephone_number": "630-347-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 SW122ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73170",
            "telephone_number": "405-692-2366",
            "fax_number": "405-692-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYAH",
        "first_name": "SHOMA",
        "middle_name": "MORIASHA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 29, 2016; 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.