Imc of Oklahoma, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4626 Issued in OK

Legal business name

IMC OF OKLAHOMA, LLC

Practice address

1105 Michelin Rd
Ardmore, OK 73401-1085

Phone

(580) 224-4446

NPI assigned

Aug 30, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Tara Nicole Atkinson

Title

Insurance & Billing Coordinator

Phone

(850) 656-1837

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1336498864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CENTENNIAL BLVD",
            "address_2": "SUITE 101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080586",
            "telephone_number": "850-656-1837",
            "fax_number": "850-877-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MICHELIN RD",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011085",
            "telephone_number": "580-224-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMC OF OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "ATKINSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "INSURANCE & BILLING COORDINATOR",
        "authorized_official_telephone_number": "850-656-1837",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heather Ingram
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• Physical Therapist in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.

Verify at the official NPI Registry.