Individual provider Active NPI

Jonathan David McMasters, PTA

  • Physical Therapy Assistant
  • Altus, OK
National Provider Identifier
1700242344
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2573 Issued in OK
Practice address
1200 E Pecan St
Altus, OK 73521-6141
Phone
(580) 379-5820
Fax
(580) 379-5829
NPI assigned
Jan 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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 2573 OK Primary

Addresses

Primary practice location

1200 E Pecan St
Altus, OK 73521-6141

Mailing address

1200 E Pecan St
Altus, OK 73521-6141
Phone (580) 379-5820

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
2573OKMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1700242344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMASTERS",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.