NPIMap

Organization Active NPI

State of Oklahoma

  • Prosthetic/Orthotic Supplier
  • Okmulgee, OK
National Provider Identifier
1770544769
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
13 Issued in OK
Legal business name
STATE OF OKLAHOMA
Practice address
1801 E 4TH St
Okmulgee, OK 74447-3942
Phone
(918) 293-5155
Fax
(918) 293-5407
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Shelley Perkins, CO,PLO,BOCOC,C.PED.
Title
Clinical Director
Phone
(918) 293-5155

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 3 OK
Prosthetic/Orthotic Supplier 335E00000X 3 OK
Prosthetic/Orthotic Supplier 335E00000X 13 OK Primary

Addresses

Primary practice location

1801 E 4TH St
Okmulgee, OK 74447-3942

Mailing address

PO Box 2506
Okmulgee, OK 74447-8501
Phone (918) 293-5155

Other identifiers 5

IdentifierTypeStateIssuer
NO NUMBER TO DATEOtherOKCOMMUNITY CARE HEALTH
NO NUMBEROtherOKLIMBS FOR LIFE
NO NUMBEROtherOKOKLAHOMA REHAB.
NO NUMBER TO DATEOtherOKCREEK NATION
NO NUMBER TO DATEOtherOKVETERANS ADMIN. HOSP.

Other names 1

  • d/b/a OSU-Omulgee Orthotic, Prosthetic and Pedorthic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sallisaw State Veterans Home140 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1770544769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2506",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744478501",
            "telephone_number": "918-293-5155",
            "fax_number": "918-293-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E 4TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744473942",
            "telephone_number": "918-293-5155",
            "fax_number": "918-293-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "918-293-5155",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CO,PLO,BOCOC,C.PED."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "OK",
            "license": "3",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OK",
            "license": "3",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OK",
            "license": "13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CARE HEALTH",
            "identifier": "NO NUMBER TO DATE",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMBS FOR LIFE",
            "identifier": "NO NUMBER",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA REHAB.",
            "identifier": "NO NUMBER",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CREEK NATION",
            "identifier": "NO NUMBER TO DATE",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERANS ADMIN. HOSP.",
            "identifier": "NO NUMBER TO DATE",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "d/b/a OSU-Omulgee Orthotic, Prosthetic and Pedorthic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Okmulgee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.