Active NPI
Shelly Conley, LPTA
- Physical Therapy Assistant
- Duncan, OK
National Provider Identifier
1093436818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 720
- Practice address
- 2150 W Elk Ave
Duncan, OK 73533-1827 - Phone
- (580) 251-8058
- NPI assigned
- Sep 9, 2022
- Last updated
- Sep 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 720 | OK | Primary |
Addresses
Primary practice location
2150 W Elk Ave
Duncan, OK 73533-1827
Mailing address
1186 County Road 1560
Rush Springs, OK 73082-3038
Phone (580) 467-3077
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 |
|---|---|---|---|
| 720 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1093436818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1186 COUNTY ROAD 1560",
"city": "RUSH SPRINGS",
"state": "OK",
"postal_code": "730823038",
"telephone_number": "580-467-3077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 W ELK AVE",
"city": "DUNCAN",
"state": "OK",
"postal_code": "735331827",
"telephone_number": "580-251-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "SHELLY",
"credential": "LPTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-09",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duncan, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.