NPIMap

Organization Active NPI

Therapytime Pediatrics

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1093838971
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1780 Issued in OK
Legal business name
THERAPYTIME PEDIATRICS
Practice address
4157 S Harvard Ave Ste 101
Tulsa, OK 74135-2606
Phone
(918) 712-7868
Fax
(918) 749-2901
NPI assigned
Apr 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Authorized official

Name
Lanette Rae Decelle, PTNPI 1891881975
Title
President
Phone
(918) 712-1868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT1780 OK Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT2077 OK

Addresses

Primary practice location

4157 S Harvard Ave Ste 101
Tulsa, OK 74135-2606

Mailing address

4157 S Harvard Ave Ste 101
Tulsa, OK 74135-2606
Phone (918) 712-7868

National Provider Directory

National Provider Directory

Locations

4157 S Harvard Ave
Ste 101
Tulsa, OK 74135
Phone (918) 712-7868

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1093838971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 S HARVARD AVE STE 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352606",
            "telephone_number": "918-712-7868",
            "fax_number": "918-749-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 S HARVARD AVE STE 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352606",
            "telephone_number": "918-712-7868",
            "fax_number": "918-749-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPYTIME PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-07",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "DECELLE",
        "authorized_official_first_name": "LANETTE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-712-1868",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT1780",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT2077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.