Individual provider Active NPI

Andrew William Kinnamon, PT

  • Physical Therapist
  • Midwest City, OK
National Provider Identifier
1205568854
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6173 Issued in OK
Practice address
9060 Harmony Dr
Midwest City, OK 73130-6218
Phone
(405) 610-8090
Fax
(405) 610-8097
NPI assigned
Jun 30, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6173 OK Primary

Addresses

Primary practice location

9060 Harmony Dr
Midwest City, OK 73130-6218

Mailing address

9060 Harmony Dr
Midwest City, OK 73130-6218
Phone (405) 610-8090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221010001290 OK Practitioner - Physical Therapist in Private Practice 3476939778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.48 of 100Reported as group
Quality
81.18
Promoting interoperability
93
Improvement activities
40
Cost
72.93

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6173OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Jun 17, 2022 Accepting new patients
Saints Medical Group, LLC CurrentSince Jun 17, 2022 Accepting new patients

Locations

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

3400 S Douglas Blvd
Oklahoma City, OK 73150
Phone (405) 815-5000

9060 Harmony Dr
Oklahoma City, OK 73130
Phone (405) 610-8090

3315 Kethley Rd
Shawnee, OK 74804
Phone (405) 273-5801

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": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1205568854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9060 HARMONY DR",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306218",
            "telephone_number": "405-610-8090",
            "fax_number": "405-610-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9060 HARMONY DR",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731306218",
            "telephone_number": "405-610-8090",
            "fax_number": "405-610-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNAMON",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.