Prime Rehab Partners, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRIME REHAB PARTNERS, LLC

Practice address

2419 N Commerce St Ste a
Ardmore, OK 73401-1357

Phone

(580) 630-5933

Fax

(580) 630-5222

NPI assigned

Aug 21, 2025

Organization subpart

No

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

Authorized official

Name

Brent Keith Holliman, PA

Title

Manager

Phone

(405) 227-1280

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Marc Flanary, PT

  • Physical Therapist
  • Broken Arrow, OK
  • NPI 1609868405
  Medicare reassignment

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1114805918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LILAC DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730347297",
            "telephone_number": "405-906-3375",
            "fax_number": "405-216-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 N COMMERCE ST STE A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011357",
            "telephone_number": "580-630-5933",
            "fax_number": "580-630-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME REHAB PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "HOLLIMAN",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-227-1280",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Lashawn President
• Jeni Presley, LPC
• Rickeal L Preston, M.S., LBP
• Tasha Renee Preston, ARNP
• Clarissa Prigmore
• Primecare Family Clinic LLC
• Proactive Enterprises LLC (ProActive Chiropractic)
• Jerica Dawn Proctor
• Nora Janie Pruitt, RN
• PTC of Ardmore, LLC

• Physical Therapist in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.