Individual provider Active NPI

Raeann Susan Thomas, PT, MPT

  • Physical Therapist
  • Newcastle, OK
National Provider Identifier
1679578959
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3557 Issued in OK
Practice address
3699 NW 32ND St
Newcastle, OK 73065-6559
Phone
(405) 387-5520
Fax
(405) 387-5404
NPI assigned
Jun 14, 2005
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 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 3557 OK Primary

Addresses

Primary practice location

3699 NW 32ND St
Newcastle, OK 73065-6559

Mailing address

2408 Old Creek Rd
Edmond, OK 73034-1537
Phone (405) 820-5075

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3557OKMDClinical Social Worker

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, 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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1679578959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 OLD CREEK RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730341537",
            "telephone_number": "405-820-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3699 NW 32ND ST",
            "city": "NEWCASTLE",
            "state": "OK",
            "postal_code": "730656559",
            "telephone_number": "405-387-5520",
            "fax_number": "405-387-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "RAEANN",
        "middle_name": "SUSAN",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "3557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newcastle, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.