Individual provider Active NPI

Kirsten Simon, PT

  • Physical Therapist
  • Edmond, OK
National Provider Identifier
1538877832
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6249 Issued in 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
Last updated
Nov 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

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

Care Compare profile

Medicare Care Compare
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, LLCGroup PAC ID 8325364151, 5 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

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

Locations

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

2412 NW 178th St
Edmond, OK 73012
Phone 4052859659 ext. 1

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1538877832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 N SOONER RD STE 150",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348333",
            "telephone_number": "405-285-9659",
            "fax_number": "405-920-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 N SOONER RD STE 150",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348333",
            "telephone_number": "405-285-9659",
            "fax_number": "405-920-6070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16502 N Pennsylvania Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730129126",
            "country_code": "US",
            "telephone_number": "405-285-9659",
            "fax_number": "405-285-8948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KIRSTEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.