Individual provider Active NPI

Jesse K McMasters, P.T.A.

  • Physical Therapy Assistant
  • Lawton, OK
National Provider Identifier
1740509637
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1777 Issued in OK
Practice address
602 SE Wallock St
Lawton, OK 73501-5403
Phone
(580) 585-5577
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2010

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 1777 OK Primary

Addresses

Primary practice location

602 SE Wallock St
Lawton, OK 73501-5403

Mailing address

2510 NW 52ND St
Apartment Fr101
Lawton, OK 73505-2014
Phone (580) 585-0873

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
1777OKMDHand Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1740509637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 NW 52ND ST",
            "address_2": "APARTMENT FR101",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735052014",
            "telephone_number": "580-585-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SE WALLOCK ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735015403",
            "telephone_number": "580-585-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMASTERS",
        "first_name": "JESSE",
        "middle_name": "K",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 18, 2010; 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.