Individual provider Active NPI

Kylee Marie Bean, PTA

  • Physical Therapy Assistant
  • Broken Arrow, OK
National Provider Identifier
1164130563
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3588 Issued in OK
Practice address
31628 E 64TH St S
Broken Arrow, OK 74014-8583
Phone
(918) 869-7784
NPI assigned
Nov 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 3588 OK Primary

Addresses

Primary practice location

31628 E 64TH St S
Broken Arrow, OK 74014-8583

Mailing address

31628 E 64TH St S
Broken Arrow, OK 74014-8583
Phone (918) 869-7784

Other names 1

  • Kylee Marie Scrapper Former name

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
3588OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1164130563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31628 E 64TH ST S",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740148583",
            "telephone_number": "918-869-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31628 E 64TH ST S",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740148583",
            "telephone_number": "918-869-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "KYLEE",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEE",
            "last_name": "SCRAPPER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.