Active NPI
Michelle Therese Mackin, RPT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1245451640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT2382
- Practice address
- 1514 E 67TH CT
Tulsa, OK 74136-3815 - Phone
- (918) 521-4273
- NPI assigned
- May 1, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2382 | OK | Primary |
Addresses
Primary practice location
1514 E 67TH CT
Tulsa, OK 74136-3815
Mailing address
1514 E 67TH CT
Tulsa, OK 74136-3815
Phone (918) 521-4273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100520000427 | OK | Practitioner - Physical Therapist in Private Practice | 1658400205 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2382 | OK | MD | Physical Therapist |
| 2382 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245451640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 E 67TH CT",
"city": "TULSA",
"state": "OK",
"postal_code": "741363815",
"telephone_number": "918-521-4273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 E 67TH CT",
"city": "TULSA",
"state": "OK",
"postal_code": "741363815",
"telephone_number": "918-521-4273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIN",
"first_name": "MICHELLE",
"middle_name": "THERESE",
"name_prefix": "Ms.",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "PT2382",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.