Active NPI
Isaac George Harjo, PTA
- Physical Therapy Assistant
- Yukon, OK
National Provider Identifier
1619745536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3331
- Practice address
- 4400 Grant Blvd Ste 105
Yukon, OK 73099-0038 - Phone
- (405) 730-0606
- Fax
- (405) 730-0554
- NPI assigned
- Dec 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3331 | OK | Primary |
Addresses
Primary practice location
4400 Grant Blvd Ste 105
Yukon, OK 73099-0038
Mailing address
4400 Grant Blvd Ste 105
Yukon, OK 73099-0038
Phone (405) 730-0606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3331 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1619745536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 GRANT BLVD STE 105",
"city": "YUKON",
"state": "OK",
"postal_code": "730990038",
"telephone_number": "405-730-0606",
"fax_number": "405-730-0554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 GRANT BLVD STE 105",
"city": "YUKON",
"state": "OK",
"postal_code": "730990038",
"telephone_number": "405-730-0606",
"fax_number": "405-730-0554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARJO",
"first_name": "ISAAC",
"middle_name": "GEORGE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-20",
"last_updated": "2023-12-20",
"certification_date": "2023-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "3331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yukon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.