Active NPI
Mechelle Petty
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1407031131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3129
- Practice address
- 7133 Riverside Pkwy
Tulsa, OK 74136-5053 - Phone
- (918) 779-6777
- NPI assigned
- Dec 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3129 | OK | Primary |
Addresses
Primary practice location
7133 Riverside Pkwy
Tulsa, OK 74136-5053
Mailing address
2213 W Xyler St
Tulsa, OK 74127-2228
Phone (918) 808-6083
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3129 | OK | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benchmark Home Health, PLC | Past | Accepting new patients |
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.
-
- Home Health Agency
- Tulsa, OK
- NPI 1831334911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631836800000",
"number": "1407031131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2213 W XYLER ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741272228",
"telephone_number": "918-808-6083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7133 RIVERSIDE PKWY",
"city": "TULSA",
"state": "OK",
"postal_code": "741365053",
"telephone_number": "918-779-6777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTY",
"first_name": "MECHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-31",
"last_updated": "2021-09-17",
"certification_date": "2021-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "3129",
"primary": true
}
],
"identifiers": [],
"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 Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.