Individual provider Active NPI

Logan J Luker, PT, DPT

  • Physical Therapist
  • Bethany, OK
National Provider Identifier
1891431375
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6171 Issued in OK
Practice address
6729 NW 39TH Expy FL 3
Bethany, OK 73008-2605
Phone
(405) 981-4001
NPI assigned
May 9, 2022
Last updated
Jun 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 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 6171 OK Primary

Addresses

Primary practice location

6729 NW 39TH Expy FL 3
Bethany, OK 73008-2605

Mailing address

808 Coles CRK
Yukon, OK 73099-2363
Phone (405) 600-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721000749 OK Practitioner - Physical Therapist in Private Practice 2860873981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

1401 SW Parkridge Blvd
Suite a
Lawton, OK 73505-9200
Phone (580) 730-8015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6171OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc. CurrentSince Jun 13, 2022 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Jun 13, 2022 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings Inc Past Accepting new patients

Locations

1401 SW Parkridge Blvd
Ste A
Lawton, OK 73505
Phone (580) 248-5668

1010 Garth Brooks Blvd
Ste 135
Yukon, OK 73099
Phone (405) 350-2000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1891431375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 COLES CRK",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730992363",
            "telephone_number": "405-600-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6729 NW 39TH EXPY FL 3",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082605",
            "telephone_number": "405-981-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKER",
        "first_name": "LOGAN",
        "middle_name": "J",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "6171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.