Individual provider Active NPI

Jimmy Royce Stanton Jr., P.T.

  • Physical Therapist
  • Lawton, OK
National Provider Identifier
1972685469
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1686 Issued in OK
Practice address
4645 W Gore Blvd
Suite E
Lawton, OK 73505-6041
Phone
(580) 355-6785
Fax
(580) 355-6788
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 1686 OK Primary

Addresses

Primary practice location

4645 W Gore Blvd
Suite E
Lawton, OK 73505-6041

Mailing address

700 NW 7TH St
Oklahoma City, OK 73102-1212
Phone (405) 609-3658

Other names 1

  • Jr Stanton Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000023 OK Practitioner - Physical Therapist in Private Practice 1658337126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Health Oklahoma Outpatient Clinics LLCGroup PAC ID 3072562412, 44 clinicians

Practice addresses (Care Compare)

5117 W Gore Blvd
Suite E
Lawton, OK 73505-5998
Phone (580) 355-6785

8355 US Hwy 277
Suite 7
Elgin, OK 73538-2207
Phone (580) 492-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1686OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
H2 Health Oklahoma Outpatient Clinics LLC Physical Therapist CurrentSince Jun 10, 2016 Accepting new patients
Valir Outpatient Clinics LLC Physical Therapist PastSince Jun 18, 2023 Accepting new patients

Locations

8355 US Highway 277
#7
Elgin, OK 73538
Phone (580) 492-1112

4645 W Gore Blvd
Ste E
Lawton, OK 73505
Phone (580) 355-6785

5117 W Gore Blvd
Ste E
Lawton, OK 73505
Phone (580) 355-6785

700 NW 7th St
Oklahoma City, OK 73102
Phone (405) 609-3600

700 NW 7th St
Ste 118
Oklahoma City, OK 73102

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1972685469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NW 7TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731021212",
            "telephone_number": "405-609-3658",
            "fax_number": "800-506-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 W GORE BLVD",
            "address_2": "SUITE E",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056041",
            "telephone_number": "580-355-6785",
            "fax_number": "580-355-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANTON",
        "first_name": "JIMMY",
        "middle_name": "ROYCE",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "1686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JR",
            "last_name": "STANTON",
            "credential": "P.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.