Kimberly Odquist, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

4385 Issued in OK

Practice address

6800 NW 39TH Expy
Bethany, OK 73008-2513

Phone

(405) 440-9866

Fax

(404) 440-6747

NPI assigned

May 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Coates Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1306106216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 NW 39TH EXPY",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082513",
            "telephone_number": "405-440-9866",
            "fax_number": "404-440-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 NW 39TH EXPY",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082513",
            "telephone_number": "405-440-9866",
            "fax_number": "404-440-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODQUIST",
        "first_name": "KIMBERLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OK",
            "license": "4385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200433030A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "COATES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Physical Therapist in Bethany, OK
• Providers in Bethany, OK by specialty
• Pediatric Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.