Neo Orthopedic and Rehabilitation LLC
Organization Active NPI Physical Therapist · Miami, OK
NPI 1720153638 · NPPES record last updated Oct 24, 2018
Key facts
- NPI
- 1720153638
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- NEO ORTHOPEDIC 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
- Organization subpart
- No
Authorized official
- Name
- Mykellyn Lopez Fuser
- Title
- Admin Assist/Owner
- Phone
- (918) 542-4101
Practitioners 53
-
Paige Hall, DPT
-
Jennifer L. Myrick, M.S., CCC-SLP
-
Anna Lisa Rokke, M.A.
-
Jason Michael Fuser, P.T.
-
Rhonda Stork, PT
-
Skyler Austin, PTA
-
Kristi Lynette Baker, RRT
-
Nicholas Ray Baron, PTA
-
Tori Boyd, PTA
-
Kara L Bruton, COTA/L
-
Julie Buchanan, PTA
-
Braden G Crawford, PTA
-
Debra C Darrah, SLPA
-
Brooklyn Betty Fuser, SLPA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Locations
2123 S Main St
Ste Ef
Grove, OK 74344
Phone (918) 542-4101
2123 S Main St
Ste F
Grove, OK 74344
2225 N Main St
Miami, OK 74354
Phone (918) 542-4101
1505 E Steve Owens Blvd
Miami, OK 74354
Phone (918) 540-4101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
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
- NEO Orthopedics and Rehabilitation LLC
Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.