Active NPI
Tara R. Gilbert, LPTA
- Physical Therapy Assistant
- Altus, OK
National Provider Identifier
1992925770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1062
- Practice address
- 1200 E Pecan St
Altus, OK 73521-6141 - Phone
- (580) 379-5820
- Fax
- (580) 379-5829
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1062 | OK | Primary |
Addresses
Primary practice location
1200 E Pecan St
Altus, OK 73521-6141
Mailing address
2520 N Robin St
Altus, OK 73521-1557
Phone (580) 480-1685
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201108000A | Medicaid | OK |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rehab@direct.jcmh.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1062 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Interoperability endpoints
- rehab@direct.jcmh.com
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1992925770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 N ROBIN ST",
"city": "ALTUS",
"state": "OK",
"postal_code": "735211557",
"telephone_number": "580-480-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 E PECAN ST",
"city": "ALTUS",
"state": "OK",
"postal_code": "735216141",
"telephone_number": "580-379-5820",
"fax_number": "580-379-5829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILBERT",
"first_name": "TARA",
"middle_name": "R.",
"name_prefix": "Mrs.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "1062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201108000A",
"state": "OK"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rehab@direct.jcmh.com",
"affiliation": "N",
"address_1": "1200 E Pecan St",
"city": "Altus",
"state": "OK",
"country_code": "US",
"postal_code": "735216141",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Altus, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.