Dan Charboneau, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2218 Issued in OK

Practice address

511 N Monte Vista St
Ada, OK 74820-4611

Phone

(580) 436-3633

Fax

(580) 436-2977

NPI assigned

Jun 14, 2006

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Performance Center, PLLC

  • Physical Therapist
  • Ada, OK
  • NPI 1336273317
  Authorized official Same address or phone

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1770526667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204611",
            "telephone_number": "580-436-3633",
            "fax_number": "580-436-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204611",
            "telephone_number": "580-436-3633",
            "fax_number": "580-436-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONEAU",
        "first_name": "DAN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Oklahoma Family Medical Center, Inc. (Central Oklahoma Family Medical Center Ada Pharmacy)
• Central Oklahoma Family Medical Center, Inc. (The Clinic Pharmacy on Arlington)
• Central Oklahoma Family Medical Center, Inc.
• Sherri R Chandler, MS
• Toni Chappell, B.A.
• Roger John Charboneau, D.O.
• Semira Charboneau, D.O.
• Charles R Vest M.D.
• Scott Charlton, PHARM. D.
• Cameron Chavez, LMSW

• Physical Therapist in Ada, OK
• Providers in Ada, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.