Individual provider Active NPI

Stormy R Deaton

  • Physical Therapy Assistant
  • Grove, OK
National Provider Identifier
1972757136
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1642 Issued in OK
Practice address
62531 E 252 Rd
Grove, OK 74344-7462
Phone
(918) 961-8067
NPI assigned
Nov 13, 2008
Last updated
Nov 13, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1642 OK Primary

Addresses

Primary practice location

62531 E 252 Rd
Grove, OK 74344-7462

Mailing address

62531 E 252 Rd
Grove, OK 74344-7462
Phone (918) 961-8067

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

LicenseStateTypeSpecialty
1642OKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1972757136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62531 E 252 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743447462",
            "telephone_number": "918-961-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62531 E 252 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743447462",
            "telephone_number": "918-961-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATON",
        "first_name": "STORMY",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.