Individual provider Active NPI

Ryan Copley, PT, DPT

  • Physical Therapist
  • Edmond, OK
National Provider Identifier
1649689241
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4866 Issued in OK
Practice address
16325 N May Ave Ste A4
Edmond, OK 73013-9142
Phone
(405) 900-6503
Fax
(405) 883-3060
NPI assigned
Aug 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 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 4866 OK Primary

Addresses

Primary practice location

16325 N May Ave Ste A4
Edmond, OK 73013-9142

Mailing address

16325 N May Ave Ste A4
Edmond, OK 73013-9142
Phone (405) 900-6503

Other identifiers 1

IdentifierTypeStateIssuer
200547830AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150206000332 OK Practitioner - Physical Therapist in Private Practice 9032434469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascent Physical Therapy and Performance LLCGroup PAC ID 0648513234, 2 clinicians

Practice addresses (Care Compare)

16325 N May Ave
Suite A4
Edmond, OK 73013-9142
Phone (405) 900-6503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ascent Physical Therapy and Performance LLC Physical Therapist CurrentSince Jun 10, 2019 Accepting new patients

Locations

16325 N May Ave
Ste A4
Edmond, OK 73013
Phone (405) 900-6503

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": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1649689241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16325 N MAY AVE STE A4",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730139142",
            "telephone_number": "405-900-6503",
            "fax_number": "405-883-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16325 N MAY AVE STE A4",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730139142",
            "telephone_number": "405-900-6503",
            "fax_number": "405-883-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPLEY",
        "first_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200547830A",
            "state": "OK"
        }
    ],
    "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 Apr 15, 2019; 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.