Individual provider Active NPI

Kaisha Lewis, PT, DPT

  • Physical Therapist
  • Bethany, OK
National Provider Identifier
1306578380
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6199 Issued in OK
Practice address
6800 NW 39TH Expy
Bethany, OK 73008-2513
Phone
(405) 789-6711
NPI assigned
Jun 28, 2022
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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 6199 OK Primary

Addresses

Primary practice location

6800 NW 39TH Expy
Bethany, OK 73008-2513

Mailing address

6475 36TH Ave NW Apt 434
Norman, OK 73072-1330
Phone (602) 292-4267

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928001243 OK Practitioner - Physical Therapist in Private Practice 5294189924 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Regional Providers Specialty CareGroup PAC ID 5496900706, 143 clinicians

Practice addresses (Care Compare)

724 24TH Ave NW
100 Phys Perform Ctr
Norman, OK 73069-6214
Phone (405) 447-1571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6199OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Physical Therapy Inc Physical Therapist CurrentSince Aug 15, 2023 Accepting new patients
Norman Regional Providers Specialty Care CurrentSince May 1, 2024 Accepting new patients

Locations

2000 Ann Branden Blvd
Ste 201
Norman, OK 73071
Phone (405) 515-0520

2000 Ann Branden Blvd
Ste 202
Norman, OK 73071
Phone (405) 253-1850

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

724 24th Ave NW
Ste 100
Norman, OK 73069
Phone (405) 447-1571

9309 E Reno Ave
Oklahoma City, OK 73130
Phone (405) 732-3353

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1306578380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 36TH AVE NW APT 434",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730721330",
            "telephone_number": "602-292-4267"
        },
        {
            "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": "405-789-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KAISHA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.