NPIMap

Organization Active NPI

Eagle Sports Medicine

  • Rehabilitation Clinic/Center
  • Edmond, OK
National Provider Identifier
1942624135
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
2813 Issued in OK
Legal business name
EAGLE SPORTS MEDICINE
Practice address
2501 E Memorial Rd
Edmond, OK 73013-5525
Phone
(405) 425-1960
Fax
(405) 425-1962
NPI assigned
Feb 10, 2014
Last updated
Oct 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Ms. Michelle Lea Krause, PT/ATCNPI 1891764148
Title
Rehabilitation Coordinator
Phone
(580) 272-4978

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 2813 OK Primary

Addresses

Primary practice location

2501 E Memorial Rd
Edmond, OK 73013-5525

Mailing address

2501 E Memorial Rd
Edmond, OK 73013-5525
Phone (405) 425-1960

National Provider Directory

National Provider Directory
Tax ID family
Eagle Sports Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1942624135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E MEMORIAL RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135525",
            "telephone_number": "405-425-1960",
            "fax_number": "405-425-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E MEMORIAL RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135525",
            "telephone_number": "405-425-1960",
            "fax_number": "405-425-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "KRAUSE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "REHABILITATION COORDINATOR",
        "authorized_official_telephone_number": "580-272-4978",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT/ATC"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "OK",
            "license": "2813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 26, 2016; 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.