Active NPI
Michelle Dunham
- Physical Therapy Assistant
- Stillwater, OK
National Provider Identifier
1174989768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2472
- Practice address
- 1215 S Western Rd
Stillwater, OK 74074-5151 - Phone
- (843) 530-5682
- NPI assigned
- Jan 12, 2016
- 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 Therapy Assistant | 225200000X | 2472 | OK | Primary |
Addresses
Primary practice location
1215 S Western Rd
Stillwater, OK 74074-5151
Mailing address
920 S Murphy St Apt 8101
Stillwater, OK 74074-1755
Phone (843) 530-5682
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 |
|---|---|---|---|
| 2472 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452556800000",
"number": "1174989768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 S MURPHY ST APT 8101",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740741755",
"telephone_number": "843-530-5682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 S WESTERN RD",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740745151",
"telephone_number": "843-530-5682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-12",
"last_updated": "2016-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "2472",
"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 Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.