Active NPI
Michael Daniel Evans, PTA
- Physical Therapy Assistant
- Oklahoma City, OK
National Provider Identifier
1306277249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2298
- Practice address
- 815 NW 12TH St
Oklahoma City, OK 73106-6802 - Phone
- (405) 230-9575
- Fax
- (405) 228-2569
- NPI assigned
- Dec 3, 2013
- Sex
- Male
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | 2298 | OK | Primary |
Addresses
Primary practice location
815 NW 12TH St
Oklahoma City, OK 73106-6802
Mailing address
815 NW 12TH St
Oklahoma City, OK 73106-6802
Phone (405) 230-9575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2298 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1306277249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 NW 12TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731066802",
"telephone_number": "405-230-9575",
"fax_number": "405-228-2569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 NW 12TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731066802",
"telephone_number": "405-230-9575",
"fax_number": "405-228-2569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "MICHAEL",
"middle_name": "DANIEL",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-03",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "2298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.