Active NPI
Blake Allen
- Physical Therapy Assistant
- Tulsa, OK
National Provider Identifier
1619773082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3604
- Practice address
- 3701 N Martin Luther King Jr Blvd
Tulsa, OK 74106-6450 - Phone
- (918) 425-3583
- NPI assigned
- Feb 24, 2025
- Sex
- Unspecified or another gender identity
- 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 | 3604 | OK | Primary |
Addresses
Primary practice location
3701 N Martin Luther King Jr Blvd
Tulsa, OK 74106-6450
Mailing address
10703 N Garnett Rd Apt E101
Owasso, OK 74055-8966
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 |
|---|---|---|---|
| 3604 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740355200000",
"number": "1619773082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10703 N GARNETT RD APT E101",
"city": "OWASSO",
"state": "OK",
"postal_code": "740558966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 N MARTIN LUTHER KING JR BLVD",
"city": "TULSA",
"state": "OK",
"postal_code": "741066450",
"telephone_number": "918-425-3583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "BLAKE",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-02-24",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "3604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.