Tate Odam, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3263 Issued in OK

Practice address

304 S 29TH St
Chickasha, OK 73018-2501

Phone

(405) 224-3100

NPI assigned

Mar 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1093390957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MERCHANT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696470",
            "telephone_number": "405-809-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 S 29TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730182501",
            "telephone_number": "405-224-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODAM",
        "first_name": "TATE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "3263",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Norman",
            "affiliation": "N",
            "address_1": "304 S 29th St",
            "city": "Chickasha",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730182501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justice Nichols, LMSW
• Rachel R Nightingale
• Christina L Nix, PT
• NLH Ok Inc.
• Ocular Physicians of Chickasha, PLLC
• William Marshall Ohl, P.A.
• Okc Dental Health Associates, P.C.
• Oklahoma CVS Pharmacy LLC
• Oklahoma Mental Health Council
• Oklahoma Mental Health Council

• Physical Therapy Assistant in Chickasha, OK
• Providers in Chickasha, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.