Individual provider Active NPI

Jessica L. Guthery, PTA

  • Physical Therapy Assistant
  • Norman, OK
National Provider Identifier
1669043691
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3370 Issued in OK
Practice address
1201 W Boyd St
Norman, OK 73069-4801
Phone
(405) 366-7898
Fax
(405) 366-0010
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 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 3370 OK Primary

Addresses

Primary practice location

1201 W Boyd St
Norman, OK 73069-4801

Mailing address

1201 W Boyd St
Norman, OK 73069-4801
Phone (405) 366-7898

Other identifiers 2

IdentifierTypeStateIssuer
200997460AMedicaidOK
3370OtherOKSTATE OF OK

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
3370OKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Therafun LLC CurrentSince Jun 12, 2022 Accepting new patients

Locations

1201 W Boyd St
Norman, OK 73069
Phone (405) 366-7898

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": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1669043691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W BOYD ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730694801",
            "telephone_number": "405-366-7898",
            "fax_number": "405-366-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W BOYD ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730694801",
            "telephone_number": "405-366-7898",
            "fax_number": "405-366-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTHERY",
        "first_name": "JESSICA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200997460A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OK",
            "identifier": "3370",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.