Kirsten Simon, PT

Individual provider Active NPI Physical Therapist · Edmond, OK

NPI 1538877832 · NPPES record last updated Nov 7, 2022

Key facts

NPI
1538877832
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
6249 (OK)
Practice address
3125 N Sooner Rd Ste 150
Edmond, OK 73034-8333
Phone
(405) 285-9659
Fax
(405) 920-6070
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Function Physical Therapy, LLC (5 clinicians)

Practice addresses (Care Compare)

2412 NW 178TH St
Edmond, OK 73012-4565
Phone 40528596591

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230321000523 OK Practitioner - Physical Therapist in Private Practice 8123490232 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6249OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Function Physical Therapy, LLC Physical Therapist Current
since Sep 25, 2022
Accepting new patients

Locations

16502 N Pennsylvania Ave
Ste C
Edmond, OK 73012
Phone (405) 285-9659

3125 N Sooner Rd
Ste 150
Edmond, OK 73034
Phone (405) 285-9659

2412 NW 178th St
Edmond, OK 73012
Phone (405) 285-9659

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6249 OK Yes

Addresses

Primary practice location

3125 N Sooner Rd Ste 150
Edmond, OK 73034-8333

Mailing address

3125 N Sooner Rd Ste 150
Edmond, OK 73034-8333
Phone (405) 285-9659

Other practice location 1

16502 N Pennsylvania Ave Ste C
Edmond, OK 73012-9126
Phone (405) 285-9659

Other providers in Edmond, OK

All providers in Edmond, OK · Physical Therapist in Oklahoma

Sources for this page

Verify at the official NPI Registry.