Individual provider Active NPI

Misty McMullen, PTA

  • Physical Therapy Assistant
  • Owasso, OK
National Provider Identifier
1417498684
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1453 Issued in OK
Practice address
13720 E 86TH St N
Owasso, OK 74055-8704
Phone
(918) 609-8088
Fax
(918) 609-8089
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1453 OK Primary

Addresses

Primary practice location

13720 E 86TH St N
Owasso, OK 74055-8704

Mailing address

6585 S Yale Ave Ste 200
Tulsa, OK 74136-8315
Phone (918) 481-2767

Other practice location 1

6585 S Yale Ave Ste 310
Tulsa, OK 74136-8334
Phone (918) 502-4700

Other names 1

  • Misty Zalvidar 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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Practice Associates, Inc. Past Accepting new patients
Rheumatology & Osteoporosis Institute of Oklahoma LLC PastSince Apr 4, 2016 Accepting new patients

Organizations & group practices 2

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1417498684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6585 S YALE AVE STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368315",
            "telephone_number": "918-481-2767",
            "fax_number": "918-494-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13720 E 86TH ST N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740558704",
            "telephone_number": "918-609-8088",
            "fax_number": "918-609-8089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6585 S Yale Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741368334",
            "country_code": "US",
            "telephone_number": "918-502-4700",
            "fax_number": "918-502-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MISTY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "ZALVIDAR",
            "credential": "PTA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Owasso, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.