NPIMap

Organization Active NPI

Imagine Pediatric Therapy, PLLC

  • Pediatric Occupational Therapist
  • Owasso, OK
National Provider Identifier
1427257013
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
944 Issued in OK
Legal business name
IMAGINE PEDIATRIC THERAPY, PLLC
Practice address
12899 E 76TH St N Unit No117
Owasso, OK 74055-4026
Phone
(918) 609-6003
Fax
(918) 609-6002
NPI assigned
Jul 13, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Jessica A Sang, OTR/LNPI 1003825050
Title
Manager
Phone
(918) 269-4128

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 944 OK Primary

Addresses

Primary practice location

12899 E 76TH St N Unit No117
Owasso, OK 74055-4026

Mailing address

9930 E 510 Rd
Claremore, OK 74019-5103
Phone (918) 269-4128

National Provider Directory

National Provider Directory

Locations

12899 E 76th St N
Ste 109
Owasso, OK 74055
Phone (918) 609-6003

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1427257013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 E 510 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740195103",
            "telephone_number": "918-269-4128",
            "fax_number": "918-343-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12899 E 76TH ST N UNIT NO117",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554026",
            "telephone_number": "918-609-6003",
            "fax_number": "918-609-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SANG",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-269-4128",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OK",
            "license": "944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 20, 2008; 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.