NPIMap

Organization Active NPI

Spectrum Rehab Specialists, LLC

  • Hospitalist Physician
  • Oklahoma City, OK
National Provider Identifier
1447934047
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
SPECTRUM REHAB SPECIALISTS, LLC
Practice address
4220 N Classen Blvd Ste a
Oklahoma City, OK 73118-2434
Phone
(405) 768-5749
NPI assigned
Jun 14, 2023
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Michelle Clark
Title
Coo
Phone
(405) 768-5749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

4220 N Classen Blvd Ste a
Oklahoma City, OK 73118-2434

Mailing address

4220 N Classen Blvd Ste a
Oklahoma City, OK 73118-2434
Phone (405) 768-5749

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230802004474 OK Part B Supplier - Clinic/Group Practice 7315308616 Receives reassigned benefits from 9 practitioners
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

1145 W I 240 Service Rd
Ste F100
Oklahoma City, OK 73139
Phone (405) 898-9048

1145 W I 240 Service Rd
Ste I100
Oklahoma City, OK 73139
Phone (405) 632-1783

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1447934047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 N CLASSEN BLVD STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182434",
            "telephone_number": "405-768-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 N CLASSEN BLVD STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182434",
            "telephone_number": "405-768-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM REHAB SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "405-768-5749"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.