Rhonda Stork, PT
Individual provider Active NPI Physical Therapist · Galena, KS
NPI 1124357447 · NPPES record last updated Dec 30, 2011
Key facts
- NPI
- 1124357447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 114435 (MO)
- Practice address
- 444 Four States Dr
Ste 1
Galena, KS 66379-4325 - Phone
- (620) 783-4441
- Fax
- (620) 783-4090
- NPI assigned
- Dec 15, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wyandotte Nation
Practice addresses (Care Compare)
1 Turtle Dr
Wyandotte, OK 74370-2114
Phone (918) 678-2282
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211130000521 | OK | Practitioner - Physical Therapist in Private Practice | 4789712092 | Reassigns benefits to 1 organization |
| I20250922001379 | TX | Practitioner - Physical Therapist in Private Practice | 4789712092 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2409 | OK | MD | General Practice Dentistry |
| 114435 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neo Orthopedic and Rehabilitation LLC | Physical Therapist | Current |
Accepting new patients |
| Orthopaedic Specialists of the Four States LLC | Past | Accepting new patients |
Locations
2123 S Main St
Ste F
Grove, OK 74344
2225 N Main St
Miami, OK 74354
Phone (918) 542-4101
116 S Wilson St
Vinita, OK 74301
Phone (918) 256-6459
1 Turtle Dr
Wyandotte, OK 74370
Phone (918) 678-2282
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 114435 | MO | Yes |
Addresses
Primary practice location
444 Four States Dr
Ste 1
Galena, KS 66379-4325
Mailing address
PO Box 2546
Joplin, MO 64803-2546
Phone (620) 783-4441
Other providers in Galena, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.