Active NPI
Breck Dean Burkhart, DPT
- Physical Therapist
- Guymon, OK
National Provider Identifier
1689185647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5182
- Practice address
- 815 NW 4TH St
Guymon, OK 73942-4626 - Phone
- (580) 651-7534
- NPI assigned
- Oct 18, 2017
- Last updated
- Dec 21, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5182 | OK | Primary |
Addresses
Primary practice location
815 NW 4TH St
Guymon, OK 73942-4626
Mailing address
815 NW 4TH St
Guymon, OK 73942-4626
Phone (580) 651-7534
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200925970A | Medicaid | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5182 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1689185647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 NW 4TH ST",
"city": "GUYMON",
"state": "OK",
"postal_code": "739424626",
"telephone_number": "580-651-7534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 NW 4TH ST",
"city": "GUYMON",
"state": "OK",
"postal_code": "739424626",
"telephone_number": "580-651-7534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKHART",
"first_name": "BRECK",
"middle_name": "DEAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-18",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "5182",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200925970A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Guymon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.