Individual provider Active NPI

Nathan Spencer

  • Physical Therapist
  • Moore, OK
National Provider Identifier
1427805589
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6531 Issued in OK
Practice address
2100 N Eastern Ave Ste 4
Moore, OK 73160-5684
Phone
(405) 676-6030
Fax
(405) 676-6031
NPI assigned
May 6, 2024
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6531 OK Primary

Addresses

Primary practice location

2100 N Eastern Ave Ste 4
Moore, OK 73160-5684

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (726) 202-3039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240521004650 OK Practitioner - Physical Therapist in Private Practice 9830531995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PTMS 3.0 LLCGroup PAC ID 2365768231, 115 clinicians

Practice addresses (Care Compare)

2100 N Eastern Ave
Suite 4 PTC East Moore
Moore, OK 73160-5684
Phone (405) 676-6030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6531OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
PTMS 3.0, LLC Physical Therapist CurrentSince May 2, 2024 Accepting new patients
PTMS 3.0, LLC Physical Therapist CurrentSince May 2, 2024 Accepting new patients

Locations

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

2100 N Eastern Ave
Ste 4
Moore, OK 73160
Phone (405) 676-6030

440 Merchant Dr
Norman, OK 73069
Phone (405) 579-1600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1427805589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "726-202-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N EASTERN AVE STE 4",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605684",
            "telephone_number": "405-676-6030",
            "fax_number": "405-676-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.