Mikayla Little, PT
Individual provider Active NPI Physical Therapist · Purcell, OK
NPI 1700554383 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1700554383
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 5954 (OK)
- Practice address
- 1438 Hardcastle Blvd
Purcell, OK 73080-8233 - Phone
- (405) 527-4700
- NPI assigned
- Aug 31, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210924000942 | TX | Practitioner - Physical Therapist in Private Practice | 5890192405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5954 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasaw Nation Division of Health | Current |
Accepting new patients | |
| Chickasaw Nation Division of Health | Current |
Accepting new patients | |
| Chickasaw Nation Division of Health | Current | Accepting new patients |
Locations
1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570
2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181
1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700
817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5954 | OK | Yes |
Addresses
Primary practice location
1438 Hardcastle Blvd
Purcell, OK 73080-8233
Mailing address
1921 Stonecipher Dr
Ada, OK 74820-3439
Phone (580) 436-3980
Other providers in Purcell, OK
- Holly Kowalsky
- Larry K. Killebrew, MD, Inc
- Carrie Law
- Dirk L Lenaburg
- Ashleigh Dyan Lippe
- Autum Looney
- Danica M. Lott
- Janet Love
- Kenneth Love, Jr
- Stephanie Madden
All providers in Purcell, OK · Physical Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.