Individual provider Active NPI

Karissa Dawn Rowley, PT, DPT

  • Physical Therapist
  • Rolla, MO
National Provider Identifier
1831736347
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5208 Issued in OK
Practice address
575A Blues Lake Pkwy
Rolla, MO 65401-8587
Phone
(573) 364-2425
NPI assigned
Dec 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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 5208 OK Primary

Addresses

Primary practice location

575A Blues Lake Pkwy
Rolla, MO 65401-8587

Mailing address

1112 Melody Dr
Ardmore, OK 73401-3559
Phone (580) 465-4399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427002066 TX Practitioner - Physical Therapist in Private Practice 3476961673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2510 Chickasaw Blvd
Ardmore, OK 73401-1341
Phone (580) 226-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5208OKMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health Current Accepting new patients
Chickasaw Nation Division of Health CurrentSince Mar 1, 2021 Accepting new patients
Chickasaw Nation Division of Health CurrentSince Mar 1, 2021 Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1831736347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 MELODY DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013559",
            "telephone_number": "580-465-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575A BLUES LAKE PKWY",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654018587",
            "telephone_number": "573-364-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWLEY",
        "first_name": "KARISSA",
        "middle_name": "DAWN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.