Individual provider Active NPI

Jordan Kaelin Kight, PTA

  • Physical Therapy Assistant
  • Tulsa, OK
National Provider Identifier
1760120984
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3510 Issued in OK
Practice address
4008 S Yale Ave
Tulsa, OK 74135-6017
Phone
(918) 622-4278
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 3510 OK Primary

Addresses

Primary practice location

4008 S Yale Ave
Tulsa, OK 74135-6017

Mailing address

PO Box 721018
Norman, OK 73070-4786

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
3510OKMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1760120984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 721018",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356017",
            "telephone_number": "918-622-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIGHT",
        "first_name": "JORDAN",
        "middle_name": "KAELIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.