Individual provider Active NPI

Christy L Willman, PT

  • Physical Therapist
  • Durant, OK
National Provider Identifier
1083882732
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3098 Issued in OK
Practice address
1004 N 19TH Ave
BLDG #4
Durant, OK 74701-3016
Phone
(580) 931-3300
Fax
(580) 931-3301
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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 3098 OK Primary

Addresses

Primary practice location

1004 N 19TH Ave
BLDG #4
Durant, OK 74701-3016

Mailing address

2232 W Houston St
Broken Arrow, OK 74012-3529
Phone (918) 259-9522

Other identifiers 1

IdentifierTypeStateIssuer
200131840AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080411000141 OK Practitioner - Physical Therapist in Private Practice 4284711490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Therapy Specialists, LLCGroup PAC ID 1759294689, 16 clinicians

Practice addresses (Care Compare)

1004 N 19TH Ave
BLDG 4
Durant, OK 74701-3017
Phone (580) 931-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3098OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Therapy Specialists, LLC Physical Therapist CurrentSince Mar 1, 2008 Accepting new patients
Excel Therapy Specialists, LLC Physical Therapist CurrentSince Mar 1, 2008 Accepting new patients

Locations

2234 W Houston St
Ste B
Broken Arrow, OK 74012
Phone (918) 259-1888

2232 W Houston St
Broken Arrow, OK 74012
Phone (918) 259-1888

1004 N 19th Ave
Bldg 4
Durant, OK 74701
Phone (580) 920-2231

2424 E 21st St
Ste 400
Tulsa, OK 74114
Phone (918) 743-9235

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": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1083882732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123529",
            "telephone_number": "918-259-9522",
            "fax_number": "918-259-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 N 19TH AVE",
            "address_2": "BLDG #4",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747013016",
            "telephone_number": "580-931-3300",
            "fax_number": "580-931-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMAN",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "3098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200131840A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.