Tony Thottukadavil, C.O.

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

C52463 Issued in OK

Practice address

4207 W Memorial Rd
Oklahoma City, OK 73134

Phone

(405) 525-4000

NPI assigned

Mar 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1447782339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8236 NW 160TH TER",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133350",
            "telephone_number": "718-285-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 W MEMORIAL RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73134",
            "telephone_number": "405-525-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8258 262nd St",
            "address_purpose": "LOCATION",
            "city": "Glen Oaks",
            "state": "NY",
            "postal_code": "110041513",
            "country_code": "US",
            "telephone_number": "718-285-5398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOTTUKADAVIL",
        "first_name": "TONY",
        "name_prefix": "Mr.",
        "credential": "C.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "OK",
            "license": "C52463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mandi M Thornton, B.S.
• Talon Thornton
• Annie Thorp, MS, RD/LD
• Kristin K Thorp, MD
• Cynthia Ann Thorsen, B.S.
• Thousand Branches Professionals Florida PLLC (Thousand Branches Wellness OKC)
• Derenda Thrailkill
• Vicki Renee Threadgill, APRN NNP BC
• India Threats
• Dante Threatt

• Orthotist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Orthotist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.