John Robert De Cleene Jr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5280 Issued in OK

Practice address

2475 Boardwalk
Norman, OK 73069-6332

Phone

(405) 447-1991

Fax

(405) 447-1198

NPI assigned

Oct 20, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1538670294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 BOARDWALK",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696332",
            "telephone_number": "405-447-1991",
            "fax_number": "405-447-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 BOARDWALK",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696332",
            "telephone_number": "405-447-1991",
            "fax_number": "405-447-1198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3744 Cleveland Ave N Apt 215",
            "address_purpose": "LOCATION",
            "city": "Arden Hills",
            "state": "MN",
            "postal_code": "551123266",
            "country_code": "US",
            "telephone_number": "920-964-1454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE CLEENE",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Norman, OK
• Providers in Norman, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.