Active NPI
Sheryl Gillespie, PTA
- Physical Therapy Assistant
- Vinita, OK
National Provider Identifier
1073833315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-02103
- Practice address
- 735 N Foreman St
Vinita, OK 74301-1422 - Phone
- (918) 256-9207
- Fax
- (918) 256-9209
- NPI assigned
- Jun 9, 2010
- Last updated
- Jun 9, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-02103 | KS | Primary |
Addresses
Primary practice location
735 N Foreman St
Vinita, OK 74301-1422
Mailing address
1805 Oak LN
Miami, OK 74354-1463
Phone (918) 541-5351
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14-02103 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276041600000",
"number": "1073833315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 OAK LN",
"city": "MIAMI",
"state": "OK",
"postal_code": "743541463",
"telephone_number": "918-541-5351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 N FOREMAN ST",
"city": "VINITA",
"state": "OK",
"postal_code": "743011422",
"telephone_number": "918-256-9207",
"fax_number": "918-256-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "SHERYL",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2010-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-02103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vinita, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.