Active NPI
Tea Pegues
- Athletic Trainer
- Tulsa, OK
National Provider Identifier
1194592741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 5871768
- Practice address
- 1414 E 39TH St Apt 146
Tulsa, OK 74105-3388 - Phone
- (720) 557-2947
- NPI assigned
- Dec 5, 2023
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 5871768 | ID | Primary |
Addresses
Primary practice location
1414 E 39TH St Apt 146
Tulsa, OK 74105-3388
Mailing address
522 W Cashmere Rd
Boise, ID 83702-1622
Phone (720) 557-2947
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000057995 | Other | BOARD OF CERTIFICATION |
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 |
|---|---|---|---|
| 5871768 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755302400000",
"number": "1194592741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 W CASHMERE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837021622",
"telephone_number": "720-557-2947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 E 39TH ST APT 146",
"city": "TULSA",
"state": "OK",
"postal_code": "741053388",
"telephone_number": "720-557-2947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEGUES",
"first_name": "TEA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-05",
"last_updated": "2025-08-16",
"certification_date": "2025-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "5871768",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION",
"identifier": "2000057995",
"state": null
}
],
"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 Aug 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.