Active NPI
Misty McMullen, PTA
- Physical Therapy Assistant
- Owasso, OK
National Provider Identifier
1417498684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1453
- 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
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 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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Practice Associates, Inc. | Past | Accepting new patients | |
| Rheumatology & Osteoporosis Institute of Oklahoma LLC | Past | 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.
-
- Internal Medicine Physician
- Stillwater, OK
- NPI 1033172168
-
- Rheumatology Physician
- Tulsa, OK
- NPI 1558716480
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.