Active NPI
Megan J Moddelmog, MSPT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1174591069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3715
- Practice address
- 8011 S Sheridan Rd
Ste B
Tulsa, OK 74133 - Phone
- (918) 481-3390
- Fax
- (918) 481-3510
- NPI assigned
- Mar 8, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3715 | OK | Primary |
Addresses
Primary practice location
8011 S Sheridan Rd
Ste B
Tulsa, OK 74133
Mailing address
8011 S Sheridan Rd
Ste B
Tulsa, OK 74133
Phone (918) 481-3390
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3715 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Tulsa Physical Therapy Limited Partnership | Physical Therapist | Past | Accepting new patients |
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 Therapy Clinic/Center
- Jenks, OK
- NPI 1487730958
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174591069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8011 S SHERIDAN RD",
"address_2": "STE B",
"city": "TULSA",
"state": "OK",
"postal_code": "74133",
"telephone_number": "918-481-3390",
"fax_number": "918-481-3510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8011 S SHERIDAN RD",
"address_2": "STE B",
"city": "TULSA",
"state": "OK",
"postal_code": "74133",
"telephone_number": "918-481-3390",
"fax_number": "918-481-3510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODDELMOG",
"first_name": "MEGAN",
"middle_name": "J",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "3715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.