Individual provider Active NPI

Blake Connor Tubbs

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1881550606
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6811 Issued in OK
Practice address
9309 E Reno Ave
Oklahoma City, OK 73130-3321
Phone
(918) 471-0202
NPI assigned
Dec 26, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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 6811 OK Primary

Addresses

Primary practice location

9309 E Reno Ave
Oklahoma City, OK 73130-3321

Mailing address

1101 Bedford Dr
Nichols Hills, OK 73116-6401
Phone (918) 471-0202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260323000462 OK Practitioner - Physical Therapist in Private Practice 3577047190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3047 Ave U
Brooklyn, NY 11229

9309 E Reno Ave
Midwest City, OK 73130-3321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6811OKMDPhysical Therapist

Organizations & group practices 1

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": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1881550606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BEDFORD DR",
            "city": "NICHOLS HILLS",
            "state": "OK",
            "postal_code": "731166401",
            "telephone_number": "918-471-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9309 E RENO AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731303321",
            "telephone_number": "918-471-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "BLAKE",
        "middle_name": "CONNOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6811",
            "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 Dec 26, 2025; 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.