Individual provider Active NPI

Kristin Alexis Henson, DPT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1447980818
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6137 Issued in OK
Practice address
7401 Riverside Pkwy Unit 219
Tulsa, OK 74136-5057
Phone
(918) 810-0263
Fax
(539) 202-5007
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 6137 OK Primary

Addresses

Primary practice location

7401 Riverside Pkwy Unit 219
Tulsa, OK 74136-5057

Mailing address

7401 Riverside Pkwy Unit 219
Tulsa, OK 74136-5057
Phone (918) 810-0263

Other practice location 1

9540 N Garnett Rd Ste 101
Owasso, OK 74055-4410
Phone (918) 609-1300

Other practice location 2

9136 S Sheridan Rd Ste B
Tulsa, OK 74133-5328
Phone (918) 488-9991

Other names 1

  • Kristin Alexis Butcher Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805001995 OK Practitioner - Physical Therapist in Private Practice 0840672929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6137OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Mobile Health Care Physical Therapist CurrentSince Jun 13, 2024 Accepting new patients
Certified Credentialing, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1447980818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 RIVERSIDE PKWY UNIT 219",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365057",
            "telephone_number": "918-810-0263",
            "fax_number": "539-202-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 RIVERSIDE PKWY UNIT 219",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365057",
            "telephone_number": "918-810-0263",
            "fax_number": "539-202-5007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9540 N Garnett Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Owasso",
            "state": "OK",
            "postal_code": "740554410",
            "country_code": "US",
            "telephone_number": "918-609-1300",
            "fax_number": "918-609-1318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9136 S Sheridan Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741335328",
            "country_code": "US",
            "telephone_number": "918-488-9991",
            "fax_number": "918-488-9989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSON",
        "first_name": "KRISTIN",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "BUTCHER",
            "middle_name": "ALEXIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.