NPIMap

Organization Active NPI

Redbud Physical Rehabilitation PC

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1356339659
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REDBUD PHYSICAL REHABILITATION PC
Practice address
4008 S Yale Ave
Tulsa, OK 74135-6017
Phone
(918) 622-4278
Fax
(918) 622-4844
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Authorized official

Name
Mrs. Shannon Carter
Title
Human Resources
Phone
(918) 622-4126

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4008 S Yale Ave
Tulsa, OK 74135-6017

Mailing address

4812 E 33Rd St
Tulsa, OK 74135-2038
Phone (918) 622-4126

Other identifiers 12

IdentifierTypeStateIssuer
200034500HMedicaidOK
700522061OtherOKMEDICARE
200034500AMedicaidOK
CJ4389OtherMEDICARE RAILROAD
200034500EMedicaidOK
200034500BMedicaidOK
200034500FMedicaidOK
200034500IMedicaidOK
200034500AOtherOKMEDICAID LEGACY
200034500DMedicaidOK
200034500CMedicaidOK
200034500GMedicaidOK

National Provider Directory

National Provider Directory

Locations

1621 S Eucalyptus Ave
Broken Arrow, OK 74012
Phone (918) 252-0513

1700 W Albany St
Ste 310
Broken Arrow, OK 74012
Phone (918) 252-0513

707 W Main St
Collinsville, OK 74021
Phone (918) 371-2800

200 N Main St
Sand Springs, OK 74063

1119 E 4th St
Tulsa, OK 74120
Phone (918) 382-0200

4004 S Yale Ave
Tulsa, OK 74135
Phone (918) 622-4126

3030 E 91st St
Tulsa, OK 74137
Phone (918) 299-6651

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1356339659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 E 33RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352038",
            "telephone_number": "918-622-4126",
            "fax_number": "918-270-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356017",
            "telephone_number": "918-622-4278",
            "fax_number": "918-622-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDBUD PHYSICAL REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "918-622-4126",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500H",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "700522061",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ4389",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500F",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500I",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LEGACY",
            "identifier": "200034500A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500D",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034500G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.