Donald Joseph Lauderdale I, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT795 Issued in OK

Practice address

1723 Kansas Ave
Woodward, OK 73801-2909

Phone

(580) 256-4050

Fax

(580) 256-4072

NPI assigned

Jul 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Physical Therapy Health & Sports Care, Inc.

  • Physical Therapy Clinic/Center
  • Woodward, OK
  • NPI 1962588855
  NPD (past) Authorized official

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1194923359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 KANSAS AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738012909",
            "telephone_number": "580-256-4050",
            "fax_number": "580-256-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 KANSAS AVE",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738012909",
            "telephone_number": "580-256-4050",
            "fax_number": "580-256-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDERDALE",
        "first_name": "DONALD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek King
• Kenan Kirkendall, D.O.
• Walter Ray Klassen, MD
• Robbie Knight, LPC
• Erin Paige Kruckenberg, PA-C
• Natalie Rae Laverty, M.A., C.C.C. - S.L.P
• Courtney Lawellin
• Amanda Diane Lawson
• Lynsay Leatherbury, COTA
• Alyssa Lee Marie Lee

• All providers in Woodward, OK
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.