NPIMap

Organization Active NPI

Cornelson Physical Therapy

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1831716968
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CORNELSON PHYSICAL THERAPY
Practice address
6020 NW 120TH CT
Oklahoma City, OK 73162-1729
Phone
(405) 751-9955
NPI assigned
Jul 6, 2020
Last updated
Sep 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Authorized official

Name
Kenna CornelsonNPI 1437628393
Title
Owner
Phone
(405) 618-1933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

6020 NW 120TH CT
Oklahoma City, OK 73162-1729

Mailing address

12104 Dornick Dr
Oklahoma City, OK 73162-6905

National Provider Directory

National Provider Directory

Locations

6020 NW 120th Ct
Oklahoma City, OK 73162
Phone (405) 728-2869

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1831716968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12104 DORNICK DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731626905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 NW 120TH CT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731621729",
            "telephone_number": "405-751-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELSON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-09-11",
        "certification_date": "2020-08-24",
        "status": "A",
        "authorized_official_last_name": "CORNELSON",
        "authorized_official_first_name": "KENNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-618-1933"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "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 Sep 11, 2020; 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.