Individual provider Active NPI

Ken M Schaecher, P.T.

  • Physical Therapist
  • Stillwater, OK
National Provider Identifier
1154592376
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2879 Issued in OK
Practice address
904 W 6TH Ave
Stillwater, OK 74074-4301
Phone
(405) 743-0101
Fax
(405) 743-1116
NPI assigned
Mar 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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 2879 OK Primary

Addresses

Primary practice location

904 W 6TH Ave
Stillwater, OK 74074-4301

Mailing address

904 W 6TH Ave
Stillwater, OK 74074-4301
Phone (405) 743-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080814000650 OK Practitioner - Physical Therapist in Private Practice 2365517083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2879OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Health Oklahoma Outpatient Clinics LLC Physical Therapist CurrentSince Oct 9, 2023 Accepting new patients

Locations

706 S 1st St
Blackwell, OK 74631
Phone (580) 363-1111

8355 US Highway 277
#7
Elgin, OK 73538
Phone (580) 492-1112

2211 N 14th St
Ponca City, OK 74601
Phone (580) 765-0101

904 W 6th Ave
Stillwater, OK 74074
Phone (405) 743-0101

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": "1205539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1154592376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744301",
            "telephone_number": "405-743-0101",
            "fax_number": "405-743-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W 6TH AVE",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744301",
            "telephone_number": "405-743-0101",
            "fax_number": "405-743-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAECHER",
        "first_name": "KEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-15",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.