Staci Barton, PTA

Individual provider Active NPI Physical Therapy Assistant · Moore, OK

NPI 1801445366 · NPPES record last updated Sep 8, 2019

Key facts

NPI
1801445366
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2702 (OK)
Practice address
400 N Eastern Ave
Moore, OK 73160-5833
Phone
(405) 601-4303
NPI assigned
Sep 8, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2702OKMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Quest Pediatric Therapy Past Accepting new patients
Rehabsource, LLC Past
since May 13, 2003
Accepting new patients
Rehabsource-Therapy at Work, LLC Past Accepting new patients
Quest Norman LLC Past
since Apr 11, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2702 OK Yes

Addresses

Primary practice location

400 N Eastern Ave
Moore, OK 73160-5833

Mailing address

4821 N Independence Ave
Oklahoma City, OK 73112-5948
Phone (402) 276-5587

Other practice location 1

4350 Will Rogers Pkwy Ste 600
Oklahoma City, OK 73108-1808
Phone (405) 948-2813

Other providers in Moore, OK

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

Sources for this page

Verify at the official NPI Registry.