Jacob Charles Thomas

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5890 Issued in OK

Practice address

19629 NE 23Rd St
Harrah, OK 73045-9305

Phone

(405) 454-0010

NPI assigned

Oct 8, 2020

Last updated

Oct 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1912504333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730450746",
            "telephone_number": "405-454-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19629 NE 23RD ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730459305",
            "telephone_number": "405-454-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3209 S Broadway Ste 105",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730134063",
            "country_code": "US",
            "telephone_number": "405-546-4797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5002 S Anderson Rd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731503800",
            "country_code": "US",
            "telephone_number": "405-732-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JACOB",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "5890",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Stober, LCMHC,LCAS, LPC
• Jennifer Swank, COTA
• Suzanne Tarver
• The Family Care Center of Harrah, Inc.
• The Office of Counseling Services
• Troy William Tippeconnic
• Natalie Valentine
• Rebecca D Webster, MED, LPC
• Breanna Marie Wesselhoft, APRN FNPC
• Megan Wilkey, PTA

• Physical Therapist in Harrah, OK
• Providers in Harrah, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.