Individual provider Active NPI

Tracy Dawn McKeever, PTA

  • Physical Therapy Assistant
  • Waurika, OK
National Provider Identifier
1477260461
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
576 Issued in OK
Practice address
Hwy 70 & Hwy 81
Waurika, OK 73573
Phone
(580) 228-2344
NPI assigned
Oct 31, 2022
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 576 OK Primary

Addresses

Primary practice location

Hwy 70 & Hwy 81
Waurika, OK 73573

Mailing address

1705 Clover Cir
Duncan, OK 73533-1405
Phone (580) 475-7515

Other identifiers 1

IdentifierTypeStateIssuer
576OtherOKPTA LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
576OKMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1477260461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CLOVER CIR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331405",
            "telephone_number": "580-475-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 70 & HWY 81",
            "city": "WAURIKA",
            "state": "OK",
            "postal_code": "73573",
            "telephone_number": "580-228-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEEVER",
        "first_name": "TRACY",
        "middle_name": "DAWN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "576",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waurika, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.