Individual provider Active NPI

Jeremy Beau Rapp, MPT

  • Physical Therapist
  • Hooker, OK
National Provider Identifier
1396935201
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
122 E Glaydas
Hooker, OK 73945
Phone
(580) 652-1111
Fax
(580) 652-1112
NPI assigned
Jul 26, 2007
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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 Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, KS2 enrollments

Enrollment records 2

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

Care Compare profile

Medicare Care Compare
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, LLCGroup PAC ID 0840517314, 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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

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

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1396935201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E GLAYDAS AVE",
            "city": "HOOKER",
            "state": "OK",
            "postal_code": "73945",
            "telephone_number": "580-652-1111",
            "fax_number": "580-652-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E GLAYDAS",
            "city": "HOOKER",
            "state": "OK",
            "postal_code": "73945",
            "telephone_number": "580-652-1111",
            "fax_number": "580-652-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1452 N Western Ave",
            "address_purpose": "LOCATION",
            "city": "Liberal",
            "state": "KS",
            "postal_code": "679012212",
            "country_code": "US",
            "telephone_number": "620-624-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAPP",
        "first_name": "JEREMY",
        "middle_name": "BEAU",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2021-02-12",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hooker, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; 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.