Active NPI
Chandler Enkey
- Physical Therapy Assistant
- Broken Arrow, OK
National Provider Identifier
1952056384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3046
- Practice address
- 1251 W Houston St
Broken Arrow, OK 74012-3734 - Phone
- (539) 367-4500
- NPI assigned
- Feb 14, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 3046 | OK | Primary |
Addresses
Primary practice location
1251 W Houston St
Broken Arrow, OK 74012-3734
Mailing address
1214 N Green Country Blvd
Haskell, OK 74436-2407
Phone (918) 606-8130
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 |
|---|---|---|---|
| 3046 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1952056384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 N GREEN COUNTRY BLVD",
"city": "HASKELL",
"state": "OK",
"postal_code": "744362407",
"telephone_number": "918-606-8130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 W HOUSTON ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740123734",
"telephone_number": "539-367-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENKEY",
"first_name": "CHANDLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-02-14",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "3046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.