Individual provider Active NPI

Tracey Deann Hanshew, RPT

  • Physical Therapy Clinic/Center
  • Chickasha, OK
National Provider Identifier
1376266353
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2385 Issued in OK
Practice address
2701 S 9TH St
Chickasha, OK 73018-6744
Phone
(405) 224-3593
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2385 OK Primary

Addresses

Primary practice location

2701 S 9TH St
Chickasha, OK 73018-6744

Mailing address

1717 Clearwater Dr
Norman, OK 73071-4341

Other names 1

  • Tracey Deann Sandison Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2385OKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1376266353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 CLEARWATER DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730714341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S 9TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730186744",
            "telephone_number": "405-224-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSHEW",
        "first_name": "TRACEY",
        "middle_name": "DEANN",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OK",
            "license": "2385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "SANDISON",
            "middle_name": "DEANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chickasha, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.