Active NPI
Tina C Small, MD
- Physical Medicine & Rehabilitation Physician
- Lawton, OK
National Provider Identifier
1720074255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 24054
- Practice address
- 5109 W Gore Blvd
Lawton, OK 73505-5998 - Phone
- (580) 699-2495
- Fax
- (580) 699-2515
- NPI assigned
- Sep 20, 2005
- 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 Medicine & Rehabilitation Physician | 208100000X | 24054 | OK | Primary |
Addresses
Primary practice location
5109 W Gore Blvd
Lawton, OK 73505-5998
Mailing address
4301 Wilson St
Fort Sill, OK 73503-4472
Phone (580) 558-8497
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00166228 | Other | RAILROAD MEDICARE | |
| 487023200 | Other | OK | DOL |
| 200038730A | Medicaid | OK | |
| 7664685 | Other | OK | AETNA |
Other names 1
- Tina C Beaty
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041027000180 | OK | Practitioner - Physical Medicine and Rehabilitation | 0648232256 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Medicine and Rehabilitation
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Spine Care of Oklahoma LLC
Practice addresses (Care Compare)
508 W 15TH St
Edmond, OK 73013-3615
Phone (405) 615-0290
Hospital & facility affiliations
- Memorial Health
- Duncan Regional Hospital, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24054 | OK | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine Care of Oklahoma, LLC | Current | Accepting new patients | |
| Physiatry Services Inc | Physical Medicine & Rehabilitation | Past | Accepting new patients |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Locations
508 W 15th St
Edmond, OK 73013
Phone (405) 615-0290
5109 W Gore Blvd
Lawton, OK 73505
Phone (405) 840-5100
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 and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Cache, OK
- NPI 1679748495
Physical Medicine & Rehabilitation
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776470400000",
"number": "1720074255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 WILSON ST",
"city": "FORT SILL",
"state": "OK",
"postal_code": "735034472",
"telephone_number": "580-558-8497",
"fax_number": "580-429-0819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5109 W GORE BLVD",
"city": "LAWTON",
"state": "OK",
"postal_code": "735055998",
"telephone_number": "580-699-2495",
"fax_number": "580-699-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALL",
"first_name": "TINA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-20",
"last_updated": "2026-04-18",
"certification_date": "2026-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "OK",
"license": "24054",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00166228",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOL",
"identifier": "487023200",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200038730A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7664685",
"state": "OK"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TINA",
"last_name": "BEATY",
"middle_name": "C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.