Regina Renee Jacobs, PT
Individual provider Active NPI Physical Therapist · Harrah, OK
NPI 1124040290 · NPPES record last updated Nov 8, 2019
Key facts
- NPI
- 1124040290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3653 (OK)
- Practice address
- 19629 NE 23Rd St
Harrah, OK 73045 - Phone
- (405) 454-0010
- Fax
- (405) 454-0030
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3653 | OK | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HJ Enterprises | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 3653 | OK | |
| Physical Therapist | 225100000X | 3653 | OK | Yes |
Addresses
Primary practice location
19629 NE 23Rd St
Harrah, OK 73045
Mailing address
PO Box 746
Harrah, OK 73045
Phone (405) 454-0010
Other names
- Mrs. Regina Renee Holland
Other providers in Harrah, OK
- Robyn Hildebrand
- Sheila Ann Howell
- Susan Kaye Hunt
- Icare Center LLC
- Impressions Dental of Harrah
- Patricia Kay Jones
- Tiffany Keenum
- Lauren Kelley
- Keeli L Kessinger
- Denean Marie Knapp
All providers in Harrah, OK · Physical Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.