Active NPI
Gary R Robinson, MS, PT, PCS
- Pediatric Physical Therapist
- Tishomingo, OK
National Provider Identifier
1154538445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1108
- Practice address
- One Murray Campus
Nah #108
Tishomingo, OK 73460-0391 - Phone
- (580) 310-4314
- Fax
- (580) 371-9844
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1108 | OK | Primary |
Addresses
Primary practice location
One Murray Campus
Nah #108
Tishomingo, OK 73460-0391
Mailing address
PO Box 391
Tishomingo, OK 73460-0391
Phone (580) 310-4314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1108 | OK | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Rehab LLC | Current | Accepting new patients |
Locations
1107 W Broadway St
Ardmore, OK 73401
Phone (580) 226-5566
1405 4th Ave NW
Ardmore, OK 73401
Phone (580) 226-5566
307 4th Ave SE
Ardmore, OK 73401
Phone (580) 300-3010
105 N 5th Ave
Ste A
Madill, OK 73446
Phone (580) 872-4277
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.
-
- Physical Therapist
- Madill, OK
- NPI 1447480082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154538445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 391",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734600391",
"telephone_number": "580-310-4314",
"fax_number": "580-371-9844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE MURRAY CAMPUS",
"address_2": "NAH #108",
"city": "TISHOMINGO",
"state": "OK",
"postal_code": "734600391",
"telephone_number": "580-310-4314",
"fax_number": "580-371-9844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "GARY",
"middle_name": "R",
"credential": "MS, PT, PCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OK",
"license": "1108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tishomingo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.