Individual provider Active NPI

Amy E Thompson, PT

  • Physical Therapist
  • Ardmore, OK
National Provider Identifier
1376550780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2243 Issued in OK
Practice address
2002 12TH Ave NW
Ste a
Ardmore, OK 73401-1227
Phone
(580) 226-9235
Fax
(580) 226-9239
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2243 OK Primary

Addresses

Primary practice location

2002 12TH Ave NW
Ste a
Ardmore, OK 73401-1227

Mailing address

2232 W Houston St
Broken Arrow, OK 74012-3529
Phone (918) 259-9522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050428000351 OK Practitioner - Physical Therapist in Private Practice 1052365855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2002 12TH Ave NW
Suite a
Ardmore, OK 73401-1206
Phone (580) 226-9235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2243OKMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Excel-Ardmore LLC Physical Therapist CurrentSince Jun 1, 2007 Accepting new patients

Locations

2002 12th Ave NW
Ste A
Ardmore, OK 73401
Phone (580) 226-9235

2234 W Houston St
Ste B
Broken Arrow, OK 74012
Phone (918) 259-1888

2232 W Houston St
Broken Arrow, OK 74012
Phone (918) 259-1888

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376550780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123529",
            "telephone_number": "918-259-9522",
            "fax_number": "918-259-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 12TH AVE NW",
            "address_2": "STE A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011227",
            "telephone_number": "580-226-9235",
            "fax_number": "580-226-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.