Active NPI
Jeffrey Rondle Parker, DPT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1679822142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5273
- Practice address
- 4008 S Yale Ave
Tulsa, OK 74135-6017 - Phone
- (918) 622-4278
- NPI assigned
- Aug 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT3490 | AR | |
| Physical Therapist | 225100000X | 24313 | MD | |
| Physical Therapist | 225100000X | 5273 | OK | Primary |
Addresses
Primary practice location
4008 S Yale Ave
Tulsa, OK 74135-6017
Mailing address
1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (812) 628-3060
Other practice location 1
1401 Conowingo Rd
Suite C
Bel Air, MD 21014-1809
Phone (410) 420-2257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5273 | OK | MD | Clinical Social Worker |
| PT3490 | AR | MD | Physical Therapist |
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.
-
- Physical Therapy Clinic/Center
- Tulsa, OK
- NPI 1710437306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672790400000",
"number": "1679822142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 LYNDON FARM CT STE 300",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402235005",
"telephone_number": "812-628-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4008 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741356017",
"telephone_number": "918-622-4278"
}
],
"practiceLocations": [
{
"address_1": "1401 Conowingo Rd",
"address_2": "Suite C",
"address_purpose": "LOCATION",
"city": "Bel Air",
"state": "MD",
"postal_code": "210141809",
"country_code": "US",
"telephone_number": "410-420-2257",
"fax_number": "410-420-2267",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARKER",
"first_name": "JEFFREY",
"middle_name": "RONDLE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-30",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT3490",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24313",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "5273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.