Individual provider Active NPI

Kristin Marie Mitchell, MS, PT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1457326928
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4069 Issued in OK
Practice address
2488 E 81St St Ste 290
Tulsa, OK 74137-4265
Phone
(918) 494-2665
Fax
(918) 927-3198
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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 PT 27375 CA
Physical Therapist 225100000X 4069 OK Primary

Addresses

Primary practice location

2488 E 81St St Ste 290
Tulsa, OK 74137-4265

Mailing address

2488 E 81St St Ste 290
Tulsa, OK 74137-4265
Phone (918) 927-3737

Other practice location 1

6475 S Yale Ave Ste 301
Tulsa, OK 74136
Phone (918) 494-2665

Other identifiers 1

IdentifierTypeStateIssuer
200241180AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090513000069 OK Practitioner - Physical Therapist in Private Practice 0941359491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics of Oklahoma PLLCGroup PAC ID 8426320912, 90 clinicians

Practice addresses (Care Compare)

2488 E 81St St
Suite 290
Tulsa, OK 74137-4265
Phone (918) 494-2665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4069OKMDChiropractor
PT 27375CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics of Oklahoma PLLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Advanced Orthopedics of Oklahoma PLLC Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Group Practice Associates, Inc. Past Accepting new patients

Locations

205 E B St
Jenks, OK 74037
Phone (918) 299-4411

2488 E 81st St
Ste 290
Tulsa, OK 74137
Phone (918) 494-2665

6475 S Yale Ave
Ste 301
Tulsa, OK 74136
Phone (918) 494-9300

6585 S Yale Ave
Ste 200
Tulsa, OK 74136
Phone (918) 481-2767

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGJHAD

Organizations & group practices 3

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1457326928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-927-3737",
            "fax_number": "918-927-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6475 S Yale Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "74136",
            "country_code": "US",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 27375",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200241180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 14, 2020; 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.