Mikala Dawn Reznik, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1146074 Issued in TX

Practice address

1508 N Grandview Ave Ste 5
Odessa, TX 79761-3040

Phone

(432) 888-9070

NPI assigned

Feb 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Mikala Dawn Ratliff Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Permian Basin Rehabilitation Center

  • Audiologist
  • Odessa, TX
  • NPI 1992918585
  NPD (past)
• Permian Basin Rehabilitation Center for Crippled Children and Adults

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Odessa, TX
  • NPI 1104958701

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1205158300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 N GRANDVIEW AVE STE 5",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797613040",
            "telephone_number": "432-889-9070",
            "fax_number": "432-552-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 N GRANDVIEW AVE STE 5",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797613040",
            "telephone_number": "432-888-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNIK",
        "first_name": "MIKALA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1146074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1146074",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://my.practicebetter.io/",
            "affiliation": "N",
            "endpointDescription": "Cloud-based EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cloud-based EMR",
            "address_1": "1508 N Grandview Ave Ste 5",
            "city": "Odessa",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797613040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIKALA",
            "last_name": "RATLIFF",
            "middle_name": "DAWN",
            "prefix": "DR.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Joseph Reynolds
• Reznik Orthodontics, LLP
• Derek Reznik, D.D.S., M.S.
• Megan Nicole Reznik, DDS, MS
• Michael Louis Reznik, D.D.S.
• RGV Eye Center LLC
• Christopher Rhonor
• Nicole Taylor Richart, AUD
• Bobby Ray Richter, D C
• Louis E Ridgway III, M.D.

• Physical Therapist in Odessa, TX
• Providers in Odessa, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.