Active NPI
Jenna L Anderson, PT, DPT
- Physical Therapist
- Bethany, OK
National Provider Identifier
1114359098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5090
- Practice address
- 6800 NW 39TH Expy
Bethany, OK 73008-2513 - Phone
- (405) 789-6711
- Fax
- (405) 438-3834
- NPI assigned
- Aug 2, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5090 | OK | Primary |
Addresses
Primary practice location
6800 NW 39TH Expy
Bethany, OK 73008-2513
Mailing address
6800 NW 39TH Expy
Bethany, OK 73008-2513
Phone (405) 789-6711
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5090 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Children'S Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Medical Specialty Clinic/Center
- Bethany, OK
- NPI 1881780450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510099200000",
"number": "1114359098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 NW 39TH EXPY",
"city": "BETHANY",
"state": "OK",
"postal_code": "730082513",
"telephone_number": "405-789-6711",
"fax_number": "405-438-3834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 NW 39TH EXPY",
"city": "BETHANY",
"state": "OK",
"postal_code": "730082513",
"telephone_number": "405-789-6711",
"fax_number": "405-438-3834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JENNA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-02",
"last_updated": "2017-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "5090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethany, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.