Southeastern Oklahoma Outpatient Rehab

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SOUTHEASTERN OKLAHOMA OUTPATIENT REHAB

Practice address

1425 Lincoln Rd
Suite B-3
Idabel, OK 74745-7345

Phone

(580) 286-4842

Fax

(903) 735-5399

NPI assigned

Sep 9, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nancy Barlow

Title

Administrator

Phone

(903) 614-4402

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093709628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3070",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755043070",
            "telephone_number": "903-735-5356",
            "fax_number": "903-735-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 LINCOLN RD",
            "address_2": "SUITE B-3",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747457345",
            "telephone_number": "580-286-4842",
            "fax_number": "903-735-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN OKLAHOMA OUTPATIENT REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BARLOW",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-614-4402"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "441764286001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Skelton, P.T.
• Jennifer Nicole Skieens
• Joseph Stanley Smith, PHARMD
• Raymond W Smith, MD
• Southeastern Oklahoma Family Services, Inc.
• Southern Oklahoma Treatment Serices, Inc.
• Southern Oklahoma Treatment Services, Inc.
• Charity Stafford, SLP
• Stathealth Clinic
• Stathealth Clinic PLLC (Stathealth Clinic)

• Physical Therapist in Idabel, OK
• Providers in Idabel, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.