Individual provider Active NPI

Trey Ratzlaff, PTA

  • Physical Therapy Assistant
  • Stillwater, OK
National Provider Identifier
1194942102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TA627 Issued in OK
Practice address
1810 N Perkins Road
Stillwater, OK 74075
Phone
(405) 624-6592
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TA627 OK Primary

Addresses

Primary practice location

1810 N Perkins Road
Stillwater, OK 74075

Mailing address

402 E. Maple
Cushing, OK 74023
Phone (918) 225-0336

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

LicenseStateTypeSpecialty
TA627OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority Past Accepting new patients
Stillwater Medical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194942102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E. MAPLE",
            "city": "CUSHING",
            "state": "OK",
            "postal_code": "74023",
            "telephone_number": "918-225-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 N PERKINS ROAD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74075",
            "telephone_number": "405-624-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATZLAFF",
        "first_name": "TREY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "TA627",
            "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 Jul 8, 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.