Tiffany Rae Pannell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1674 Issued in OK

Practice address

6705 E 81St St
Ste. 170
Tulsa, OK 74133-4171

Phone

(918) 710-5790

NPI assigned

Apr 14, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Eric C Smith LLC

  dba KEE Physical Therapy

  • Physical Therapist
  • Tulsa, OK
  • NPI 1871002915
  NPD

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1326734013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W. WALNUT ST",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "74429",
            "telephone_number": "918-520-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 E 81ST ST",
            "address_2": "STE. 170",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334171",
            "telephone_number": "918-710-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNELL",
        "first_name": "TIFFANY",
        "middle_name": "RAE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Jay Pangburn, DO
• Molly Pangestu
• Nicole Pankey, RN
• Barrett Pannell, OD
• Shavonda Pannell, D.C.
• Mahima Bhetuwal Panta, FNP-C
• Emma Panter
• Tracey Pantin-Gomez
• Jordan Judith Paolucci, DO
• Nathalia Jordana Papa Belini, MD

• Physical Therapy Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.