Organization Active NPI

Regeneration Physical Therapy of Weatherford, PLLC

  • Physical Therapy Clinic/Center
  • Weatherford, OK
National Provider Identifier
1104022540
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2818 Issued in OK
Legal business name
REGENERATION PHYSICAL THERAPY OF WEATHERFORD, PLLC
Practice address
1801 Liberty
Weatherford, OK 73096-9609
Phone
(580) 772-2662
Fax
(580) 772-2241
NPI assigned
Jun 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Authorized official

Name
Jeff Scott Moses, PTNPI 1316994189
Title
Physical Therapist
Phone
(580) 772-2662

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2818 OK Primary

Addresses

Primary practice location

1801 Liberty
Weatherford, OK 73096-9609

Mailing address

PO Box 512
Weatherford, OK 73096-0512
Phone (580) 772-2662

Other identifiers 2

IdentifierTypeStateIssuer
100835090AMedicaidOK
1316994189OtherOKNPI TYPE 1

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051115000515 OK Part B Supplier - Clinic/Group Practice 2668491044 Receives reassigned benefits from 1 practitioner
Practice locations: Weatherford, OK

National Provider Directory

National Provider Directory

Locations

1801 Liberty
Weatherford, OK 73096
Phone (580) 772-2262

Practitioners & affiliated clinicians

Practitioners 2

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": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1104022540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730960512",
            "telephone_number": "580-772-2662",
            "fax_number": "580-772-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LIBERTY",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730969609",
            "telephone_number": "580-772-2662",
            "fax_number": "580-772-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATION PHYSICAL THERAPY OF WEATHERFORD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "580-772-2662",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OK",
            "license": "2818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100835090A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1316994189",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.