Keland Jerome Mask, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1821 Issued in OK

Practice address

6904 E. Reno Avenue
Midwest City, OK 73110-2152

Phone

(405) 737-5555

Fax

(405) 737-5556

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chickasha Physical Therapy Clinic

  • Physical Therapist
  • Chickasha, OK
  • NPI 1417078668
  NPD (past)
• TSG Physical Therapy, LLC

  dba RD Therapy Services

  • Physical Medicine & Rehabilitation Physician
  • Edmond, OK
  • NPI 1992753834
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1285688861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6904 E. RENO AVENUE",
            "city": "MEDWEST CITY",
            "state": "OK",
            "postal_code": "731102152",
            "telephone_number": "405-737-5555",
            "fax_number": "405-737-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6904 E. RENO AVENUE",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731102152",
            "telephone_number": "405-737-5555",
            "fax_number": "405-737-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASK",
        "first_name": "KELAND",
        "middle_name": "JEROME",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "1821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Martin, M.D.
• Ciara Martinez
• Damian Miguel Martinez, RPH
• Deisy Lizbeth Martinez
• La Donna Marzett-Long, BHRS
• Lindsay Marie Masquat Yellow Robe, MSW, LCSW
• Julia Massie, M.S.SLP-CCC
• Master Peace Counseling, LLC
• Charles Kanjirakattu Mathew, PHARM D
• Jerome P Mathias, MD

• Physical Medicine & Rehabilitation Physician in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; 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.