NPIMap

Organization Active NPI

Neo Orthopedic and Rehabilitation LLC

Doing business as NEO Orthopedics and Rehabilitation LLC

  • Physical Therapist
  • Miami, OK
National Provider Identifier
1720153638
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NEO ORTHOPEDIC AND REHABILITATION LLC
Doing business as
NEO Orthopedics and Rehabilitation LLC
Practice address
2225 N Main St
Miami, OK 74354-1620
Phone
(918) 542-4101
Fax
(918) 542-4410
NPI assigned
Nov 24, 2006
Last updated
Oct 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Authorized official

Name
Mykellyn Lopez Fuser
Title
Admin Assist/Owner
Phone
(918) 542-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2225 N Main St
Miami, OK 74354-1620

Mailing address

PO Box 168
Miami, OK 74355-0168
Phone (918) 542-4101

Other practice location 1

116 S Wilson St
Vinita, OK 74301-3730
Phone (918) 542-4101

Other names 1

  • NEO Orthopedics and Rehabilitation LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190124002060 OK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981941291 Receives reassigned benefits from 9 practitioners
Practice locations: Grove, OK; Vinita, OK; Miami, OK

National Provider Directory

National Provider Directory

Locations

2123 S Main St
Ste Ef
Grove, OK 74344
Phone (918) 542-4101

2123 S Main St
Ste F
Grove, OK 74344

1505 E Steve Owens Blvd
Miami, OK 74354
Phone (918) 542-4101

2225 N Main St
Miami, OK 74354
Phone (918) 542-4101

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1720153638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 168",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743550168",
            "telephone_number": "918-542-4101",
            "fax_number": "918-542-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 N MAIN ST",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541620",
            "telephone_number": "918-542-4101",
            "fax_number": "918-542-4410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 S Wilson St",
            "address_purpose": "LOCATION",
            "city": "Vinita",
            "state": "OK",
            "postal_code": "743013730",
            "country_code": "US",
            "telephone_number": "918-542-4101",
            "fax_number": "918-542-4410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEO ORTHOPEDIC AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "FUSER",
        "authorized_official_first_name": "MYKELLYN",
        "authorized_official_middle_name": "LOPEZ",
        "authorized_official_title_or_position": "ADMIN ASSIST/OWNER",
        "authorized_official_telephone_number": "918-542-4101"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEO Orthopedics and Rehabilitation LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.