Jeremy Beau Rapp, MPT

Individual provider Active NPI Physical Therapist · Hooker, OK

NPI 1396935201 · NPPES record last updated Feb 12, 2021

Key facts

NPI
1396935201
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
122 E Glaydas
Hooker, OK 73945
Phone
(580) 652-1111
Fax
(580) 652-1112
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panhandle Physical Therapy and Wellness, LLC (2 clinicians)

Practice addresses (Care Compare)

122 E Glaydas St
Physical Therapy on the Move
Hooker, OK 73945-1527
Phone (580) 652-1111

1452 N Western Ave
Liberal, KS 67901-2212
Phone (620) 624-2980

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OK, KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20070830000555 OK Practitioner - Physical Therapist in Private Practice 7214020643 Reassigns benefits to 1 organization
I20210707000286 KS Practitioner - Physical Therapist in Private Practice 7214020643 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Physical Therapy & Wellness, LLC Physical Therapist Current
since Jun 8, 2014
Accepting new patients

Locations

1452 N Western Ave
Liberal, KS 67901
Phone (620) 624-2980

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

122 E Glaydas
Hooker, OK 73945

Mailing address

122 E Glaydas Ave
Hooker, OK 73945
Phone (580) 652-1111

Other practice location 1

1452 N Western Ave
Liberal, KS 67901-2212
Phone (620) 624-2980

Other identifiers

IdentifierTypeStateIssuer
200118240AMedicaidOK
OK400025OtherOKMEDICARE PTAN

Other providers in Hooker, OK

All providers in Hooker, OK · Physical Therapist in Oklahoma

Sources for this page

Verify at the official NPI Registry.