Individual provider Active NPI

Keely Paige Lovelace, PTA

  • Physical Therapy Assistant
  • Yukon, OK
National Provider Identifier
1659008753
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3565 Issued in OK
Practice address
1824 Commons Cir Ste B
Yukon, OK 73099-9538
Phone
(405) 467-6782
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3565 OK Primary

Addresses

Primary practice location

1824 Commons Cir Ste B
Yukon, OK 73099-9538

Mailing address

1824 Commons Cir Ste B
Yukon, OK 73099-9538
Phone (405) 467-6782

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL OPTCcares.com

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

LicenseStateTypeSpecialty
3565OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Rehab, LLC CurrentSince Aug 14, 2022 Accepting new patients

Locations

1824 Commons Cir
Ste B
Yukon, OK 73099
Phone (405) 324-0961

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1659008753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 COMMONS CIR STE B",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730999538",
            "telephone_number": "405-467-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 COMMONS CIR STE B",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730999538",
            "telephone_number": "405-467-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "KEELY",
        "middle_name": "PAIGE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "OPTCcares.com",
            "affiliation": "N",
            "address_1": "1824 Commons Cir Ste B",
            "city": "Yukon",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730999538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 6, 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.

Verify at the official NPI Registry.