Active NPI
Matthew Dillon Ogg, PT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1457903635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5706
- Practice address
- 4008 S Yale Ave
Tulsa, OK 74135-6017 - Phone
- (918) 622-4278
- NPI assigned
- Jul 9, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 5706 | OK | Primary |
Addresses
Primary practice location
4008 S Yale Ave
Tulsa, OK 74135-6017
Mailing address
1417 S Fulton Ave
Tulsa, OK 74112-6321
Phone (918) 633-6971
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 |
|---|---|---|---|
| 5706 | OK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627516800000",
"number": "1457903635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 S FULTON AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741126321",
"telephone_number": "918-633-6971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4008 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741356017",
"telephone_number": "918-622-4278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OGG",
"first_name": "MATTHEW",
"middle_name": "DILLON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-09",
"last_updated": "2021-07-29",
"certification_date": "2021-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "5706",
"primary": true
}
],
"identifiers": [],
"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 Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.