Individual provider Active NPI

Dana Dale Terry, PT

  • Physical Therapist
  • Chickasha, OK
National Provider Identifier
1710961040
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1578 Issued in OK
Practice address
3410 S 4TH St
Chickasha, OK 73018-7502
Phone
(405) 222-9537
Fax
(405) 222-9566
NPI assigned
Nov 30, 2005
Last updated
Jun 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1578 OK Primary

Addresses

Primary practice location

3410 S 4TH St
Chickasha, OK 73018-7502

Mailing address

3410 S 4TH St
Chickasha, OK 73018-7502
Phone (405) 224-9675

Other identifiers 1

IdentifierTypeStateIssuer
4536410OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120229000063 OK Practitioner - Physical Therapist in Private Practice 0941275382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Health Oklahoma Outpatient Clinics LLCGroup PAC ID 3072562412, 44 clinicians

Practice addresses (Care Compare)

3410 S 4TH St
Chickasha, OK 73018-7502
Phone (405) 222-9537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1578OKMDProfessional Counselor
PT1578OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Health Oklahoma Outpatient Clinics LLC Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients
Valir Outpatient Clinics LLC Physical Therapist PastSince Jun 18, 2023 Accepting new patients

Locations

3410 S 4th St
Chickasha, OK 73018
Phone (405) 222-9537

8355 US Highway 277
#7
Elgin, OK 73538
Phone (580) 492-1112

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1710961040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 S 4TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730187502",
            "telephone_number": "405-224-9675",
            "fax_number": "405-224-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 S 4TH ST",
            "city": "CHICKASHA",
            "state": "OK",
            "postal_code": "730187502",
            "telephone_number": "405-222-9537",
            "fax_number": "405-222-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "DANA",
        "middle_name": "DALE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT1578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4536410",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chickasha, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.