Audria Jeannie Baxter – Physical Therapy Assistant

Key facts

NPI: 1780717405
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: 1513 (OK)
Practice address: 2104 N Broadway St
Suite B
Poteau, OK 74953-2501
Phone: (918) 649-0799
Fax: (918) 649-0797
NPI assigned: Mar 13, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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

Physical Therapy Inc Physical Therapist · Poteau, OK · NPI 1568412708

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
1513	OK	MD	Occupational Therapy Assistant
1388	AR	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Physical Therapy Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	1513	OK	Yes
Physical Therapy Assistant	225200000X	1388	AR

Addresses

Primary practice location

2104 N Broadway St
Suite B
Poteau, OK 74953-2501

Mailing address

2104 N Broadway St
Suite B
Poteau, OK 74953-2501
Phone (918) 649-0799

Other providers in Poteau, OK

All providers in Poteau, OK · Physical Therapy Assistant in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.