Bespoke Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BESPOKE PHYSICAL THERAPY LLC

Practice address

4907 E Galveston PL
Broken Arrow, OK 74014-2342

Phone

(918) 841-6257

Fax

(539) 399-7520

NPI assigned

Jul 25, 2024

Last updated

Jul 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nikolaus Prescott, PT, DPTNPI 1669083101

Title

Owner

Phone

(918) 841-6257

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 4

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.

• Kathryn Jackson

  • Occupational Therapist
  • Owasso, OK
  • NPI 1659241511
  Medicare reassignment Care Compare group NPD
• Cara Penick, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Bixby, OK
  • NPI 1811643653
  Medicare reassignment Care Compare group NPD
• Nikolaus Prescott, PT, DPT

  • Physical Therapist
  • Broken Arrow, OK
  • NPI 1669083101
  Medicare reassignment NPD Authorized official
• Alexandra Renee Flores, DPT

  • Physical Therapist
  • Tulsa, OK
  • NPI 1972428621
  NPD

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1952139388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4907 E GALVESTON PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740142342",
            "telephone_number": "918-841-6257",
            "fax_number": "539-399-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4907 E GALVESTON PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740142342",
            "telephone_number": "918-841-6257",
            "fax_number": "539-399-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "NIKOLAUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-841-6257",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Bentley
• Thomas Howard Berenson, O.D.
• Teresa Ann Berg, PH.D.
• Berkshire Dental Group PLC
• Cassandra Berry, RBT
• Better Living Medical Equipment & Repair LLC
• Suresh Bharani
• Rosava Lillian Bibelheimer
• Kash Kendall Biddle, DO
• Janet Aurora Bigelow

• Physical Therapy Clinic/Center in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Physical Therapy Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.