Ryan Gibson

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2712 Issued in OK

Practice address

1107 W Broadway St
Ardmore, OK 73401-2833

Phone

(580) 226-5566

Fax

(580) 226-5567

NPI assigned

Jan 10, 2022

Last updated

Jan 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Summit Rehab LLC

  dba Prohab Therapy Specialists

  • Physical Therapist
  • Madill, OK
  • NPI 1447480082

  Physical Therapy Assistant

  NPD

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1649931858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 4TH AVE NW # 296",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012708",
            "telephone_number": "580-226-5566",
            "fax_number": "580-226-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W BROADWAY ST",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012833",
            "telephone_number": "580-226-5566",
            "fax_number": "580-226-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "erinw@prohabsecure.com",
            "affiliation": "N",
            "endpointDescription": "HIPPA compliant web server",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1107 W Broadway St",
            "city": "Ardmore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "734012833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Geriatric Center of Southern Ok (The Arthritis Center)
• Gerken Orthodontics, LLC
• Craig A Gerken, DDS
• Tina Diane Gerwin, NP-C
• Gibson Counseling Services, Inc, PC
• Felicia Giddings Jefferson
• Jeri Ann Gill, PHYSICAL THERAPIST
• Bruce Stewart Gilmore, M.D.
• Karen Glenn, BHRS
• Karen Ranee Glenn, LMFT

• Physical Therapy Assistant in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.