Active NPI
Kevin Roberts, P.T.
- Physical Therapist
- Cleveland, OK
National Provider Identifier
1942512090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4048
- Practice address
- 1401 W Pawnee St
Cleveland, OK 74020-3033 - Phone
- (918) 358-2501
- NPI assigned
- Jul 6, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4048 | OK | Primary |
Addresses
Primary practice location
1401 W Pawnee St
Cleveland, OK 74020-3033
Mailing address
1401 W Pawnee St
Cleveland, OK 74020-3033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4048 | OK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1942512090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 W PAWNEE ST",
"city": "CLEVELAND",
"state": "OK",
"postal_code": "740203033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 W PAWNEE ST",
"city": "CLEVELAND",
"state": "OK",
"postal_code": "740203033",
"telephone_number": "918-358-2501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KEVIN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-06",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "4048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.