Active NPI
John Mark Heusman, MS, LAT, ATC, CSCS
- Specialist
- Oklahoma City, OK
National Provider Identifier
1104943547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- AT-82
- Practice address
- 6201 N Santa Fe Ave
Oklahoma City, OK 73118-7538 - Phone
- (405) 272-5478
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | AT-82 | OK | Primary |
Addresses
Primary practice location
6201 N Santa Fe Ave
Oklahoma City, OK 73118-7538
Mailing address
8320 NW 111TH Ter
Oklahoma City, OK 73162-2100
Phone (405) 818-7910
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-82 | OK | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104943547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8320 NW 111TH TER",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731622100",
"telephone_number": "405-818-7910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 N SANTA FE AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731187538",
"telephone_number": "405-272-5478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEUSMAN",
"first_name": "JOHN",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "MS, LAT, ATC, CSCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OK",
"license": "AT-82",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.