Individual provider Active NPI

Christopher Paul Juneau, DPT

  • Physical Therapist
  • Lawton, OK
National Provider Identifier
1902043557
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5080 Issued in OK
Practice address
4645 W Gore Blvd
Suite E
Lawton, OK 73505-6041
Phone
(405) 609-3620
Fax
(800) 506-3795
NPI assigned
Jan 17, 2009
Last updated
Jan 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009447 GA
Physical Therapist 225100000X 06529R LA
Physical Therapist 225100000X 5080 OK Primary

Addresses

Primary practice location

4645 W Gore Blvd
Suite E
Lawton, OK 73505-6041

Mailing address

700 NW 7TH St
Oklahoma City, OK 73102-1212
Phone (405) 609-3658

Other practice location 1

1400 Lera
Weatherford, OK 73096-2629
Phone (580) 772-3200

Other identifiers 1

IdentifierTypeStateIssuer
200646190AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629001679 OK Practitioner - Physical Therapist in Private Practice 8921058843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

941 W I 35 Frontage Rd
132 Athletico Physical Therapy
Edmond, OK 73034-7375
Phone (405) 227-9667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5080OKMDFamily Medicine Physician
PT009447GAMDPhysical Therapist
06529RLAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
H2 Health Oklahoma Outpatient Clinics LLC Physical Therapist CurrentSince Apr 23, 2016 Accepting new patients
Valir Outpatient Clinics LLC Physical Therapist PastSince Jun 18, 2023 Accepting new patients
Physical Therapy Specialists Inc Physical Therapist Past Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

941 W I 35 Frontage Rd
Ste 132
Edmond, OK 73034
Phone (405) 227-9667

8355 US Highway 277
#7
Elgin, OK 73538
Phone (580) 492-1112

4645 W Gore Blvd
Ste E
Lawton, OK 73505
Phone (580) 355-6785

700 NW 7th St
Oklahoma City, OK 73102
Phone (405) 609-3600

Organizations & group practices 5

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": "1232150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1902043557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NW 7TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021212",
            "telephone_number": "405-609-3658",
            "fax_number": "800-506-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 W GORE BLVD",
            "address_2": "SUITE E",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056041",
            "telephone_number": "405-609-3620",
            "fax_number": "800-506-3795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Lera",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "OK",
            "postal_code": "730962629",
            "country_code": "US",
            "telephone_number": "580-772-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNEAU",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-17",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009447",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "06529R",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200646190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.