Active NPI
Mary Denise Peabody, PT
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1457472953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 836
- Practice address
- 6525 N Meridian Ave Ste 311
Oklahoma City, OK 73116-1410 - Phone
- (405) 721-1115
- Fax
- (405) 721-2025
- NPI assigned
- Apr 2, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 836 | OK | Primary |
Addresses
Primary practice location
6525 N Meridian Ave Ste 311
Oklahoma City, OK 73116-1410
Mailing address
108 Berkshire Dr
Edmond, OK 73034-7366
Phone (405) 330-6468
Other names 1
- Mary Denise Scruggs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 836 | OK | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McBride Clinic Inc | Physical Therapist | Past | Accepting new patients |
| Careerstaff | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Oklahoma City, OK
- NPI 1891047353
-
- Orthopaedic Surgery Physician
- Oklahoma City, OK
- NPI 1053319889
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457472953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 BERKSHIRE DR",
"city": "EDMOND",
"state": "OK",
"postal_code": "730347366",
"telephone_number": "405-330-6468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6525 N MERIDIAN AVE STE 311",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731161410",
"telephone_number": "405-721-1115",
"fax_number": "405-721-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEABODY",
"first_name": "MARY",
"middle_name": "DENISE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "SCRUGGS",
"middle_name": "DENISE",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.