Individual provider Active NPI

Jeffrey David Samburg, PT, DPT, MS, OCS

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1831523414
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5855 Issued in OK
Practice address
4004 Cedar Pass Dr
Oklahoma City, OK 73179-4702
Phone
(630) 292-2761
NPI assigned
Aug 30, 2013
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5855 OK Primary

Addresses

Primary practice location

4004 Cedar Pass Dr
Oklahoma City, OK 73179-4702

Mailing address

4004 Cedar Pass Dr
Oklahoma City, OK 73179-4702
Phone (630) 292-2761

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5855OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1831523414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 CEDAR PASS DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731794702",
            "telephone_number": "630-292-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 CEDAR PASS DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731794702",
            "telephone_number": "630-292-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMBURG",
        "first_name": "JEFFREY",
        "middle_name": "DAVID",
        "credential": "PT, DPT, MS, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-30",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.