Individual provider Active NPI

Emily Elise Lucas, PTA

  • Physical Therapy Assistant
  • Altus, OK
National Provider Identifier
1790499176
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3584 Issued in OK
Practice address
1200 E Pecan St
Altus, OK 73521-6141
Phone
(580) 379-5820
Fax
(580) 379-5829
NPI assigned
Jan 10, 2023
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3584 OK Primary

Addresses

Primary practice location

1200 E Pecan St
Altus, OK 73521-6141

Mailing address

1200 E Pecan St
Altus, OK 73521-6192
Phone (580) 379-5820

Other identifiers 1

IdentifierTypeStateIssuer
201134690AMedicaidOK

Other names 1

  • Emily Elise Kelley Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rehab@direct.jcmh.com

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Current Accepting new patients

Locations

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

205 S Park Ln
Ste 100
Altus, OK 73521

Interoperability endpoints

  • Direct secure messaging: rehab@direct.jcmh.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1790499176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216192",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "EMILY",
        "middle_name": "ELISE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201134690A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rehab@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "1200 E Pecan St",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735216141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KELLEY",
            "middle_name": "ELISE",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Altus, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.