Wesley O'Brian Pack

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4417 Issued in OK

Practice address

6904 E Reno Ave
Midwest City, OK 73110-2152

Phone

(405) 610-2488

Fax

(405) 610-2484

NPI assigned

Jun 30, 2011

Sex

Male

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)

Enrolled

State licenses

Practice roles

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.

• H2 Health Oklahoma Outpatient Clinics LLC

  • Physical Therapist
  • Oklahoma City, OK
  • NPI 1982683306
  NPD (past)
• Valir Outpatient Clinics LLC

  • Physical Therapist
  • Shawnee, OK
  • NPI 1245765536
  NPD (past)

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1336436104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NW 7TH ST",
            "address_2": "SUITE 302",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021212",
            "telephone_number": "405-609-3675",
            "fax_number": "800-506-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6904 E RENO AVE",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731102152",
            "telephone_number": "405-610-2488",
            "fax_number": "405-610-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "WESLEY",
        "middle_name": "O'BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Renee Owens
• Kaylee Owings
• Owl Anesthesia Aprn-Crna, PC
• P David Margolis MD PC
• Jason Pack, MD
• Aneesh Venkat Pakala, MD
• Madeline G Palomino, RBT
• Darin E Pape, DPT
• Lisa Elaine Parenica Schooling
• Brittany Park

• Physical Therapist in Midwest City, OK
• Providers in Midwest City, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.