Ashley Diane Fanning, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4211 Issued in OK

Practice address

1125 40TH St Ste D
Woodward, OK 73801-1700

Phone

(405) 201-0204

NPI assigned

Apr 19, 2013

Last updated

Apr 19, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Physical Therapy and Sports Rehab, LLC

  • Physical Therapy Clinic/Center
  • Woodward, OK
  • NPI 1497067771

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1952745002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 OAK HOLLOW RD",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738017126",
            "telephone_number": "405-201-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 40TH ST STE D",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738011700",
            "telephone_number": "405-201-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "ASHLEY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "4211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Evans
• Shannon Nevada Fairless, BSW, CMII
• Faith Over Fear Counseling LLC
• Family Care of Woodward
• Family Care of Woodward LLC
• Taylor Farley, LPC
• L Ann Farrar, CRNA
• Cody Ferguson
• Micheal Scott Feuerborn, APRN
• Samantha L Fluitt

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.