Kimberly Rose Edwards, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5094 Issued in OK

Practice address

2234 W Houston St Ste B
Broken Arrow, OK 74012-3519

Phone

(918) 259-1888

Fax

(918) 251-3725

NPI assigned

Sep 8, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

3D PT, IncGroup PAC ID 4789686486, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 3D PT, Inc

  • Physical Therapist
  • Siloam Springs, AR
  • NPI 1730109661
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1710135330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 DAISY DR",
            "address_2": "STE F-2",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744647410",
            "telephone_number": "918-458-9235",
            "fax_number": "918-458-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2234 W HOUSTON ST STE B",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123519",
            "telephone_number": "918-259-1888",
            "fax_number": "918-251-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KIMBERLY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tami Jo Eberle
• Jason Scot Edgin
• Savannah Noelle Ediger
• Educational Therapy Center
• Elizabeth Anne Edwards Svetlic, LCSW
• Tiffany Gail Edwards, LMT
• Ashley Efaw, OTR/L
• Larissa Kaye Efird
• Elemental Health Counseling Services, LLC
• Raymond Elijah

• Physical Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.