Individual provider Active NPI

Johanna Alene Cummings, PTA

  • Physical Therapy Assistant
  • Ardmore, OK
National Provider Identifier
1720108988
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1077 Issued in OK
Practice address
1405 4TH Ave NW # 296
Ardmore, OK 73401-2708
Phone
(580) 795-4561
Fax
(580) 223-6448
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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 1077 OK Primary

Addresses

Primary practice location

1405 4TH Ave NW # 296
Ardmore, OK 73401-2708

Mailing address

1405 4TH Ave NW # 296
Ardmore, OK 73401-2708
Phone (580) 795-4561

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
1077OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1720108988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 4TH AVE NW # 296",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012708",
            "telephone_number": "580-795-4561",
            "fax_number": "580-223-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 4TH AVE NW # 296",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012708",
            "telephone_number": "580-795-4561",
            "fax_number": "580-223-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "JOHANNA",
        "middle_name": "ALENE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.