Kathryn Jackson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5790 Issued in OK

Practice address

10710 N 121St East Ave
Owasso, OK 74055-5219

Phone

(918) 857-5284

Fax

(918) 857-5284

NPI assigned

Nov 6, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bespoke Physical Therapy LLCGroup PAC ID 9436697653, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bespoke Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Broken Arrow, OK
  • NPI 1952139388
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1659241511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 N 121ST EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555219",
            "telephone_number": "918-857-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 N 121ST EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555219",
            "telephone_number": "918-857-5284",
            "fax_number": "918-857-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "5790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Mavis Ingram
• Innate Family Chiropractic, PLLC
• J Kirk & Company P C
• Cassandra Jackson-Smith, LCSW
• Ashley Jackson
• Stevan Jameson, PTA
• Bridgett Dione Jamison
• Jan Jay Rigney O.D. Inc.
• Jennifer L Reynolds OD PLLC
• Jentri Sinor Nutrition LLC

• Occupational Therapist in Owasso, OK
• Providers in Owasso, OK by specialty
• Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.