NPIMap

Organization Active NPI

Drayer Physical Therapy Oklahoma LLC

  • Physical Therapist
  • Catoosa, OK
National Provider Identifier
1770031577
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY OKLAHOMA LLC
Practice address
434 S Cherokee St
Catoosa, OK 74015-2710
Phone
(918) 266-6200
Fax
(918) 266-6206
NPI assigned
Sep 21, 2016
Last updated
Sep 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Authorized official

Name
Eric J Williams
Title
President and Ceo
Phone
(717) 220-2100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

434 S Cherokee St
Catoosa, OK 74015-2710

Mailing address

2416 Highway 45 N
Columbus, MS 39705-1320
Phone (662) 327-6705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160119002137 OK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315240744 Receives reassigned benefits from 41 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Skiatook, OK; Pryor, OK; Claremore, OK; Owasso, OK; Coweta, OK; Catoosa, OK; Broken Arrow, OK; Muskogee, OK

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Drayer Physical Therapy Oklahoma LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

434 S Cherokee St
Catoosa, OK 74015
Phone (918) 266-6200

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1770031577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 HIGHWAY 45 N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397051320",
            "telephone_number": "662-327-6705",
            "fax_number": "662-327-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 S CHEROKEE ST",
            "city": "CATOOSA",
            "state": "OK",
            "postal_code": "740152710",
            "telephone_number": "918-266-6200",
            "fax_number": "918-266-6206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "717-220-2100"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catoosa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.