Individual provider Active NPI

Beverly Hasson, P.T.

  • Physical Therapist
  • Tahlequah, OK
National Provider Identifier
1659751923
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4794 Issued in OK
Practice address
2021 Mahaney Ave Ste 6
Tahlequah, OK 74464-5795
Phone
(918) 485-5115
Fax
(918) 458-5119
NPI assigned
Jun 2, 2015
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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 4794 OK Primary

Addresses

Primary practice location

2021 Mahaney Ave Ste 6
Tahlequah, OK 74464-5795

Mailing address

PO Box 721018
Norman, OK 73070-4786
Phone (405) 809-8713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018002982 OK Practitioner - Physical Therapist in Private Practice 0941608236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redbud Physical Therapy LLCGroup PAC ID 4486939949, 32 clinicians

Practice addresses (Care Compare)

2021 Mahaney Ave
Suite 6
Tahlequah, OK 74464-5795
Phone (918) 458-5115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4794OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Redbud Physical Therapy LLC Physical Therapist CurrentSince Sep 20, 2021 Accepting new patients
Redbud Physical Therapy LLC CurrentSince Sep 20, 2021 Accepting new patients
Redbud Physical Rehabilitation PC Physical Therapist Past Accepting new patients

Locations

825 E Kenosha St
Broken Arrow, OK 74012
Phone (918) 252-0513

707 W Main St
Collinsville, OK 74021
Phone (918) 371-2800

12641 S State Highway 51
Coweta, OK 74429
Phone (918) 486-1338

500 E 141st St
Glenpool, OK 74033
Phone (918) 322-3884

1118 S Main St
Grove, OK 74344
Phone (918) 786-9883

12326 E 86th St N
Owasso, OK 74055
Phone (918) 272-1923

1486 S Elliott St
Pryor, OK 74361
Phone (918) 825-2333

200 N Main St
Ste C
Sand Springs, OK 74063
Phone (918) 227-7888

209 E Rogers Blvd
Skiatook, OK 74070
Phone (918) 396-9799

2021 Mahaney Ave
Ste 6
Tahlequah, OK 74464
Phone (918) 458-5115

4008 S Yale Ave
Tulsa, OK 74135
Phone (918) 622-4126

4526 S Peoria Ave
Tulsa, OK 74105
Phone (918) 794-9000

817 W Cherokee St
Wagoner, OK 74467
Phone (918) 485-3100

Organizations & group practices 3

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1659751923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721018",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704786",
            "telephone_number": "405-809-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 MAHANEY AVE STE 6",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645795",
            "telephone_number": "918-485-5115",
            "fax_number": "918-458-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSON",
        "first_name": "BEVERLY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.