NPIMap

Organization Active NPI

Oklahoma Manual Therapy Associates, PLLC

Doing business as CORE Physical Therapy

  • Orthopedic Physical Therapist
  • Edmond, OK
National Provider Identifier
1881699130
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
OKLAHOMA MANUAL THERAPY ASSOCIATES, PLLC
Doing business as
CORE Physical Therapy
Practice address
1410 Fretz Dr
Edmond, OK 73003-5782
Phone
(405) 285-8477
Fax
(405) 285-8499
NPI assigned
Jun 14, 2005
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Michael Shane Sims, MPT, OCS, FAAOMPTNPI 1528046596
Title
Co-Owner/ Physical Therapy
Phone
(405) 285-8477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X OK Primary

Addresses

Primary practice location

1410 Fretz Dr
Edmond, OK 73003-5782

Mailing address

1410 Fretz Dr
Edmond, OK 73003-5782
Phone (405) 285-8477

Other names 1

  • CORE Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050310000199 OK Part B Supplier - Clinic/Group Practice 7911955851 Receives reassigned benefits from 3 practitioners
Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1881699130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 FRETZ DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730035782",
            "telephone_number": "405-285-8477",
            "fax_number": "405-285-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 FRETZ DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730035782",
            "telephone_number": "405-285-8477",
            "fax_number": "405-285-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA MANUAL THERAPY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "CO-OWNER/ PHYSICAL THERAPY",
        "authorized_official_telephone_number": "405-285-8477",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT, OCS, FAAOMPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORE Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.