Kelly Marie Swan, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1353 Issued in OK

Practice address

12912 E 86TH St N
Owasso, OK 74055-8608

Phone

(918) 524-3833

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Per4Mance Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Claremore, OK
  • NPI 1922355023
  NPD (past)

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1619569852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19822 S COVEY CT",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740190041",
            "telephone_number": "918-274-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12912 E 86TH ST N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740558608",
            "telephone_number": "918-524-3833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 N Sioux Ave",
            "address_purpose": "LOCATION",
            "city": "Claremore",
            "state": "OK",
            "postal_code": "740173128",
            "country_code": "US",
            "telephone_number": "918-923-4700",
            "fax_number": "918-923-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWAN",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OK",
            "license": "460722482",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "1353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Sullivan, PHARM. D.
• Gabriela Summerlin
• Christina Lorene Summers, M.S. CCC-SLP
• Sundance Counseling Services, LLC
• Benjamin R. Swacha, D.C.
• Richelle Swearingen, PHARM D
• Keelie Mischelle Sweet, LPC
• Anthony Joseph Sylvester, PT
• Lyndsay Synnott Seleznoff
• Naomi Tabor

• Physical Medicine & Rehabilitation Physician in Owasso, OK
• Providers in Owasso, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.