Active NPI
Kemi Sogunro, PTA
- Physical Therapy Assistant
- Oklahoma City, OK
National Provider Identifier
1508639345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3295
- Practice address
- 36 W Memorial Rd
Oklahoma City, OK 73114-2325 - Phone
- (405) 755-3110
- NPI assigned
- Nov 2, 2023
- Sex
- Female
- 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 Therapy Assistant | 225200000X | 3295 | OK | Primary |
Addresses
Primary practice location
36 W Memorial Rd
Oklahoma City, OK 73114-2325
Mailing address
1329 N Elm St
Guthrie, OK 73044-1819
Phone (405) 589-2697
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3295 | OK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1508639345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1329 N ELM ST",
"city": "GUTHRIE",
"state": "OK",
"postal_code": "730441819",
"telephone_number": "405-589-2697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 W MEMORIAL RD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731142325",
"telephone_number": "405-755-3110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOGUNRO",
"first_name": "KEMI",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-02",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "3295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.