Individual provider Active NPI

Jason P Hartog, MPT

  • Physical Therapist
  • Pryor, OK
National Provider Identifier
1154512564
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4015 Issued in OK
Practice address
1486 S Elliott St
Pryor, OK 74361-8002
Phone
(918) 825-2333
Fax
(918) 825-6266
NPI assigned
Aug 9, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4015 OK Primary

Addresses

Primary practice location

1486 S Elliott St
Pryor, OK 74361-8002

Mailing address

4004 S Yale Ave
Tulsa, OK 74135-6017
Phone (918) 622-4278

Other identifiers 1

IdentifierTypeStateIssuer
7783909OtherAETNA

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1154512564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356017",
            "telephone_number": "918-622-4278",
            "fax_number": "918-270-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 S ELLIOTT ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743618002",
            "telephone_number": "918-825-2333",
            "fax_number": "918-825-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTOG",
        "first_name": "JASON",
        "middle_name": "P",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7783909",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.