NPIMap

Organization Active NPI

Drayer Physical Therapy Oklahoma LLC

  • Physical Therapist
  • Muskogee, OK
National Provider Identifier
1104292580
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY OKLAHOMA LLC
Practice address
2900 N Main St
Suite 102
Muskogee, OK 74401-4078
Phone
(918) 608-1135
Fax
(918) 608-1142
NPI assigned
Aug 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Authorized official

Name
Luke A Drayer
Title
Chairman and Founder
Phone
(717) 220-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2900 N Main St
Suite 102
Muskogee, OK 74401-4078

Mailing address

2416 Highway 45 N
Columbus, MS 39705-1320
Phone (662) 327-6705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160119002137 OK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315240744 Receives reassigned benefits from 41 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Skiatook, OK; Pryor, OK; Claremore, OK; Owasso, OK; Coweta, OK; Catoosa, OK; Broken Arrow, OK; Muskogee, OK

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Drayer Physical Therapy Oklahoma LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11319 S State Highway 51
Ste 1000
Coweta, OK 74429
Phone (918) 887-8112

2900 N Main St
Ste 102
Muskogee, OK 74401
Phone (918) 608-1135

805 W Shawnee Byp
Muskogee, OK 74401

Practitioners & affiliated clinicians

Practitioners 11

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": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1104292580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 HIGHWAY 45 N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051320",
            "telephone_number": "662-327-6705",
            "fax_number": "662-327-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N MAIN ST",
            "address_2": "SUITE 102",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014078",
            "telephone_number": "918-608-1135",
            "fax_number": "918-608-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "DRAYER",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHAIRMAN AND FOUNDER",
        "authorized_official_telephone_number": "717-220-2100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; 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.