Elite Peds Ok LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

ELITE PEDS OK LLC

Practice address

4800 W San Antonio St # 101
Broken Arrow, OK 74012-6127

Phone

(918) 417-8740

NPI assigned

Dec 8, 2022

Organization subpart

No

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

Authorized official

Name

Alexis Langston, OTRNPI 1063923951

Title

Owner

Phone

(918) 766-5233

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Elite Pediatric Therapy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexis Langston, OT

  • Occupational Therapist
  • Broken Arrow, OK
  • NPI 1063923951
  NPD Authorized official

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1417668674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 E 124TH CT S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740085894",
            "telephone_number": "918-417-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 W SAN ANTONIO ST # 101",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126127",
            "telephone_number": "918-417-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PEDS OK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "LANGSTON",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-766-5233",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201125410",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiffany Gail Edwards, LMT
• Ashley Efaw, OTR/L
• Larissa Kaye Efird
• Elemental Health Counseling Services, LLC
• Raymond Elijah
• Katie Leigh Elliott, CSFA
• Whitney Merdith Ellsworth, DRPT
• Alexandria Nicole Elrhazoui
• Clinton Wade Emerson, D.M.D.
• Meagan Emerson

• Occupational Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.