Individual provider Active NPI

Jeffrey M Wolfe, RPT

  • Physical Therapist
  • Edmond, OK
National Provider Identifier
1285732263
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT945 Issued in OK
Practice address
80 E 5TH St
Suite 200
Edmond, OK 73034-3830
Phone
(405) 330-3500
Fax
(405) 330-3505
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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 PT945 OK Primary

Addresses

Primary practice location

80 E 5TH St
Suite 200
Edmond, OK 73034-3830

Mailing address

80 E 5TH St
Suite 200
Edmond, OK 73034-3830
Phone (405) 330-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000339 OK Practitioner - Physical Therapist in Private Practice 8426042441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
945OKMDOptometrist
PT945OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Physical Therapy LLC Physical Therapist CurrentSince Feb 27, 2018 Accepting new patients

Locations

19629 NE 23rd St
Harrah, OK 73045
Phone (405) 390-4433

5002 S Anderson Rd
Oklahoma City, OK 73150
Phone (405) 454-0010

Organizations & group practices 1

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1285732263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 E 5TH ST",
            "address_2": "SUITE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343830",
            "telephone_number": "405-330-3500",
            "fax_number": "405-330-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E 5TH ST",
            "address_2": "SUITE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343830",
            "telephone_number": "405-330-3500",
            "fax_number": "405-330-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; 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.