Grand Slam Rehabilitation L.L.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

GRAND SLAM REHABILITATION L.L.C.

Practice address

6510 S Western Ave
Suite 400
Oklahoma City, OK 73139-1712

Phone

(405) 631-8888

Fax

(405) 631-9593

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Derek Prentice

Title

Managing Member

Phone

(405) 418-2200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1073560942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 S WESTERN AVE",
            "address_2": "SUITE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731391712",
            "telephone_number": "405-631-8888",
            "fax_number": "405-631-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 S WESTERN AVE",
            "address_2": "SUITE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731391712",
            "telephone_number": "405-631-8888",
            "fax_number": "405-631-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND SLAM REHABILITATION L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "405-418-2200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephani Lynn Granato, PHD
• Grand Lake Mental Health Center, Inc.
• Grand Lake Mental Health Center, Inc.
• Grand Prairie Pediatric and Allergy Clinic Inc
• Grand Primary Care Clinics
• Grand Village in Home Care
• Michael Henry Grandison, DO
• Gloria Granillo
• Grant Johnson
• Angela Donnell Grant

• Physical Therapist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.