NPIMap

Organization Active NPI

Drayer Physical Therapy Oklahoma LLC

  • Physical Therapist
  • Broken Arrow, OK
National Provider Identifier
1083080766
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY OKLAHOMA LLC
Practice address
2560 East Kenosha Street
Broken Arrow, OK 74014
Phone
(717) 220-2100
NPI assigned
Aug 17, 2015
Last updated
Aug 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Authorized official

Name
Luke A DrayerNPI 1346295664
Title
Chairman and Founder
Phone
(717) 220-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2560 East Kenosha Street
Broken Arrow, OK 74014

Mailing address

2560 East Kenosha Street
Broken Arrow, OK 74014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160119002137 OK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315240744 Receives reassigned benefits from 41 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Skiatook, OK; Pryor, OK; Claremore, OK; Owasso, OK; Coweta, OK; Catoosa, OK; Broken Arrow, OK; Muskogee, OK

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Drayer Physical Therapy Oklahoma LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1083080766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 EAST KENOSHA STREET",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 EAST KENOSHA STREET",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74014",
            "telephone_number": "717-220-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "DRAYER",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHAIRMAN AND FOUNDER",
        "authorized_official_telephone_number": "717-220-2100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.