Active NPI
Alexandra Marie Kauaianiani Zukerman, PTA
- Physical Therapy Assistant
- Lawton, OK
National Provider Identifier
1184929366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1908
- Practice address
- 602 SE Wallock St
Lawton, OK 73501-5403 - Phone
- (580) 585-5577
- Fax
- (580) 248-9377
- NPI assigned
- Jan 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 1908 | OK | Primary |
Addresses
Primary practice location
602 SE Wallock St
Lawton, OK 73501-5403
Mailing address
3501 E Gore Blvd
Apt 1328
Lawton, OK 73501-9813
Phone (580) 704-9686
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295395200000",
"number": "1184929366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 E GORE BLVD",
"address_2": "APT 1328",
"city": "LAWTON",
"state": "OK",
"postal_code": "735019813",
"telephone_number": "580-704-9686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 SE WALLOCK ST",
"city": "LAWTON",
"state": "OK",
"postal_code": "735015403",
"telephone_number": "580-585-5577",
"fax_number": "580-248-9377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUKERMAN",
"first_name": "ALEXANDRA",
"middle_name": "MARIE KAUAIANIANI",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-19",
"last_updated": "2011-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "1908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.