Guymon Physical Therapy and Wellness PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

3766 Issued in OK

Legal business name

GUYMON PHYSICAL THERAPY AND WELLNESS PLLC

Practice address

211 NW 5TH St
Guymon, OK 73942-5801

Phone

(580) 338-4789

Fax

(866) 999-0184

NPI assigned

Jun 22, 2012

Last updated

Oct 22, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacob Lee Tuttle, PTNPI 1619099942

Title

Owner/Physical Therapist

Phone

(918) 223-5075

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Guymon Physical Therapy and Wellness PLLC

  dba Beaver Therapy and Wellness

  • Physical Therapist
  • Beaver, OK
  • NPI 1760154512
  NPPES parent name

Practitioners 5

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.

• Jacob Lee Tuttle, PT

  • Physical Therapist
  • Guymon, OK
  • NPI 1619099942
  Medicare reassignment NPD Authorized official
• Rachel Inez Jones, PT

  • Physical Therapist
  • Guymon, OK
  • NPI 1346503661
  Medicare reassignment NPD
• Jason Wayne Eidson, PTA

  • Physical Therapy Assistant
  • Guymon, OK
  • NPI 1073182903
  NPD
• Kyrie A McKee, PT, DPT

  • Physical Therapist
  • Guymon, OK
  • NPI 1003331844
  NPD
• Kenzi Brown, PT, DPT

  • Physical Therapist
  • Beaver, OK
  • NPI 1720611205
  NPD (past)

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1790048882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NW 5TH ST",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739425801",
            "telephone_number": "580-338-4789",
            "fax_number": "866-999-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NW 5TH ST",
            "city": "GUYMON",
            "state": "OK",
            "postal_code": "739425801",
            "telephone_number": "580-338-4789",
            "fax_number": "866-999-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUYMON PHYSICAL THERAPY AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-22",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "TUTTLE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "918-223-5075",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OK",
            "license": "3766",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OK",
            "license": "1929",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12413288",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200459990A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gilbert G Gutierrez
• Guymon Anesthesia Management Services, LLC
• Guymon Clinic Pharmacy LLC (Clinic Pharmacy)
• Guymon Clinic Pharmacy LLC (Clinic Pharmacy)
• Guymon Emergency Medicine PLLC
• Guymon Public Schools
• Guymon Surgical Consultants LLC
• Guymon Vision Clinic
• Maricruz Haines, APRN
• Kenneth W. Harland, D.D.S.

• Physical Therapy Clinic/Center in Guymon, OK
• Providers in Guymon, OK by specialty
• Physical Therapy Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.