Individual provider Active NPI

Amy Marie Fair, PT

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1558923722
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5717 Issued in OK
Practice address
923 N Robinson Ave
Oklahoma City, OK 73102-5845
Phone
(405) 231-5800
NPI assigned
Jul 8, 2019
Last updated
Aug 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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 5717 OK Primary

Addresses

Primary practice location

923 N Robinson Ave
Oklahoma City, OK 73102-5845

Mailing address

440 Merchant Dr
Norman, OK 73069-6470
Phone (405) 809-8713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909003675 OK Practitioner - Physical Therapist in Private Practice 4789913294 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5717OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PTMS 3.0, LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
PTMS 3.0, LLC Physical Therapist Current Accepting new patients
PTMS 3.0, LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
PTMS 3.0, LLC Physical Therapist Past Accepting new patients

Locations

440 Merchant Dr
Norman, OK 73069
Phone (405) 579-1600

Organizations & group practices 4

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1558923722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MERCHANT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696470",
            "telephone_number": "405-809-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 N ROBINSON AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731025845",
            "telephone_number": "405-231-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5717",
            "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 Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.