Active NPI
Debra Lord, PHYSICAL THERAPIST
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1689768244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305203022
- Practice address
- 12201 N Western Ave
Oklahoma City, OK 73114-8022 - Phone
- (405) 752-5112
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- 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 | 2305203022 | VA | Primary |
Addresses
Primary practice location
12201 N Western Ave
Oklahoma City, OK 73114-8022
Mailing address
P.O. Box 2496
Edmond, OK 73083
Phone (540) 845-8969
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 192573 | Other | ANTHEM HEALTHKEEP PLUS | |
| 4978145 | Medicaid | VA | |
| 2111544 | Other | VA | MDIPA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2305203022 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Special Care, Inc. | Past | Accepting new patients |
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.
-
- Developmentally Disabled Services Day Training Agency
- Oklahoma City, OK
- NPI 1285725994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226880000000",
"number": "1689768244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 2496",
"city": "EDMOND",
"state": "OK",
"postal_code": "73083",
"telephone_number": "540-845-8969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12201 N WESTERN AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731148022",
"telephone_number": "405-752-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORD",
"first_name": "DEBRA",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2008-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305203022",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTHKEEP PLUS",
"identifier": "192573",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4978145",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "2111544",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.