Robert Todd Petty, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1699 Issued in OK

Practice address

5110 S Yale Ave
Ste 304
Tulsa, OK 74135-7401

Phone

(918) 398-7400

Fax

(918) 398-7440

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Excel Therapy Specialists, LLC

  • Physical Therapist
  • Tulsa, OK
  • NPI 1033277413
  Medicare reassignment NPD
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Stillwater, OK
  • NPI 1205162716

  Physical Therapist

  Medicare reassignment NPD
• Excel Therapy Specialists, LLC

  • Physical Therapist
  • Muskogee, OK
  • NPI 1942368329
  NPD
• Select Physical Therapy Holdings Inc

  • Rehabilitation Clinic/Center
  • Oklahoma City, OK
  • NPI 1386605905
  NPD
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1154383115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 W HOUSTON ST STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123519",
            "telephone_number": "918-259-1888",
            "fax_number": "918-251-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 S YALE AVE",
            "address_2": "STE 304",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357401",
            "telephone_number": "918-398-7400",
            "fax_number": "918-398-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "1699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100658250B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William J Pettit, D.O.
• Donna Lynn Petty, RN
• Jo Leslie Petty, MS ARNP
• Jonathan Paul Petty, COTA/L
• Mechelle Petty
• PF Southern Hills SNF Ops, LLC
• PF TNC SNF Ops, LLC
• Joseph Pfaff
• Brooklyn Jean Pfannenstiel
• Carinna Pfeifer

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.