Individual provider Active NPI

Shelby Brook Matlock, DPT

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1174972475
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5536 Issued in OK
Practice address
3400 S Douglas Blvd Ste 306
Oklahoma City, OK 73150-1001
Phone
(405) 772-4535
Fax
(405) 772-4537
NPI assigned
Jun 7, 2016
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1275676 TX
Physical Therapist 225100000X 5536 OK Primary

Addresses

Primary practice location

3400 S Douglas Blvd Ste 306
Oklahoma City, OK 73150-1001

Mailing address

3400 S Douglas Blvd Ste 306
Oklahoma City, OK 73150-1001
Phone (405) 772-4535

Other names 1

  • Shelby Brook Jurek Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180625001999 OK Practitioner - Physical Therapist in Private Practice 4981997467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

608 NW 9TH St
Oklahoma City, OK 73102-1049

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5536OKMDFamily Medicine Physician
1275676TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Sep 28, 2021 Accepting new patients
Saints Medical Group, LLC CurrentSince Sep 28, 2021 Accepting new patients

Locations

3400 S Douglas Blvd
Ste 306
Oklahoma City, OK 73150
Phone (405) 772-4635

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1174972475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 S DOUGLAS BLVD STE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731501001",
            "telephone_number": "405-772-4535",
            "fax_number": "405-772-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 S DOUGLAS BLVD STE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731501001",
            "telephone_number": "405-772-4535",
            "fax_number": "405-772-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "SHELBY",
        "middle_name": "BROOK",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1275676",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "JUREK",
            "middle_name": "BROOK",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.