Individual provider Active NPI

Oyerihtei Iyegha

  • Physical Therapist
  • Montgomery, AL
National Provider Identifier
1861136244
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH9644 Issued in AL
Practice address
4367 Atlanta Hwy Ste C
Montgomery, AL 36109-3171
Phone
(334) 676-2797
NPI assigned
Apr 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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 PTH9644 AL Primary

Addresses

Primary practice location

4367 Atlanta Hwy Ste C
Montgomery, AL 36109-3171

Mailing address

5520 Paddock Club Dr Apt B
Montgomery, AL 36116-4247

Other practice location 1

603 Wright St
Tuskegee, AL 36083-1585
Phone (334) 727-4960

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125000109 AL Practitioner - Physical Therapist in Private Practice 3274904578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH9644ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Consultants CurrentSince Dec 22, 2022 Accepting new patients
Veterans Wellness Center of Alabama LLC CurrentSince Apr 24, 2022 Accepting new patients

Locations

4367 Atlanta Hwy
Ste C
Montgomery, AL 36109
Phone (334) 676-2797

731 Dallas Ave
Selma, AL 36701
Phone (334) 872-4778

Organizations & group practices 2

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": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1861136244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 PADDOCK CLUB DR APT B",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361164247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4367 ATLANTA HWY STE C",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361093171",
            "telephone_number": "334-676-2797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 Wright St",
            "address_purpose": "LOCATION",
            "city": "Tuskegee",
            "state": "AL",
            "postal_code": "360831585",
            "country_code": "US",
            "telephone_number": "334-727-4960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IYEGHA",
        "first_name": "OYERIHTEI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH9644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.