Individual provider Active NPI

Mary Jill Wooten, P.T.

  • Physical Therapist
  • Oklahoma City, OK
National Provider Identifier
1962521054
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2800 Issued in OK
Practice address
9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone
(405) 230-9575
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2800 OK Primary

Addresses

Primary practice location

9600 Broadway Ext
Oklahoma City, OK 73114-7408

Mailing address

9600 Broadway Ext
Oklahoma City, OK 73114-7408
Phone (405) 486-2337

Other practice location 1

19629 NE 23rd St
Harrah, OK 73045-9305
Phone (405) 454-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180213001434 OK Practitioner - Physical Therapist in Private Practice 4880954874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9600 Broadway Ext
McBride Orthopedic Hospital
Oklahoma City, OK 73114-7408
Phone (405) 486-2100

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
81.07
Promoting interoperability
86
Improvement activities
40
Cost
69.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McBride Clinic Orthopedic Hospital, LLC CurrentSince Oct 5, 2020 Accepting new patients
McBride Clinic Orthopedic Hospital, LLC Past Accepting new patients

Locations

400 N Bryant Ave
Edmond, OK 73034
Phone (405) 230-9200

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

Interoperability endpoints

  • Direct secure messaging: jill.wooten@moh.eclinicaldirectplus.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1962521054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-486-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 BROADWAY EXT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731147408",
            "telephone_number": "405-230-9575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19629 NE 23rd St",
            "address_purpose": "LOCATION",
            "city": "Harrah",
            "state": "OK",
            "postal_code": "730459305",
            "country_code": "US",
            "telephone_number": "405-454-0010",
            "fax_number": "405-454-0030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "MARY",
        "middle_name": "JILL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "2800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.