Elijah Joseph Tedder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2970 Issued in OK

Practice address

2821 36TH Ave NW Ste 130
Norman, OK 73072-2472

Phone

(405) 310-5224

Fax

(405) 310-5225

NPI assigned

Oct 2, 2024

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1184442709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "813-560-8157",
            "fax_number": "812-590-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 36TH AVE NW STE 130",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730722472",
            "telephone_number": "405-310-5224",
            "fax_number": "405-310-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDDER",
        "first_name": "ELIJAH",
        "middle_name": "JOSEPH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A8125",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "014468",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Isabelle Tearse
• Carmen Marie Tebbe, PH.D.
• Sandra L Tedder, PHD
• Dustin Shawn Tedesco, MD
• Lacie Teehee
• Sarah Dawn Teet, DPH
• Jenna Tegtmeyer, DPT, ATC

• Physical Therapy Assistant in Norman, OK
• Providers in Norman, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.