Individual provider Active NPI

Jennifer K. Ranallo, P.T.

  • Physical Therapist
  • McAlester, OK
National Provider Identifier
1265746127
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4353 Issued in OK
Practice address
221 E Comanche Ave
McAlester, OK 74501-5845
Phone
(918) 423-1181
Fax
(918) 423-1191
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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 4353 OK Primary

Addresses

Primary practice location

221 E Comanche Ave
McAlester, OK 74501-5845

Mailing address

221 E Comanche Ave
McAlester, OK 74501-5845
Phone (918) 423-1181

Other identifiers 1

IdentifierTypeStateIssuer
200300530AMedicaidOK

Other names 1

  • Ms. Jennifer K. Martin Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000436 OK Practitioner - Physical Therapist in Private Practice 3274727482 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4353OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc Physical Therapist CurrentSince Sep 29, 2014 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Sep 29, 2014 Accepting new patients
Redbud Physical Rehabilitation PC Physical Therapist Past Accepting new patients

Locations

221 E Comanche Ave
McAlester, OK 74501
Phone (918) 423-1181

1010 Garth Brooks Blvd
Ste 135
Yukon, OK 73099
Phone (405) 350-2000

Organizations & group practices 3

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1265746127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E COMANCHE AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015845",
            "telephone_number": "918-423-1181",
            "fax_number": "918-423-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E COMANCHE AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015845",
            "telephone_number": "918-423-1181",
            "fax_number": "918-423-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANALLO",
        "first_name": "JENNIFER",
        "middle_name": "K.",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200300530A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MARTIN",
            "middle_name": "K.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in McAlester, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.

Verify at the official NPI Registry.