Individual provider Active NPI

Kristie Hodges, PTA

  • Physical Therapy Assistant
  • Midwest City, OK
National Provider Identifier
1144805565
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2016 Issued in OK
Practice address
1124 S Douglas Blvd
Midwest City, OK 73130-5236
Phone
(405) 582-2105
NPI assigned
Mar 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2016 OK Primary

Addresses

Primary practice location

1124 S Douglas Blvd
Midwest City, OK 73130-5236

Mailing address

440 Merchant Dr
Norman, OK 73069-6470

Other identifiers 1

IdentifierTypeStateIssuer
2016OtherOKPTA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Norman

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

LicenseStateTypeSpecialty
2016OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
PTMS 3.0, LLC PastSince Mar 21, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1144805565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MERCHANT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S DOUGLAS BLVD",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731305236",
            "telephone_number": "405-582-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "KRISTIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA  LICENSE",
            "identifier": "2016",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Norman",
            "affiliation": "N",
            "address_1": "1124 S Douglas Blvd",
            "city": "Midwest City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731305236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.