Unknown Individual – Physical Therapist, NPI 1417956228

Unknown Individual is a healthcare provider. based in Ardmore, Oklahoma. specializing in Physical Therapist. They hold a License No. 833 (OK). The NPI Number for Unknown Individual is 1417956228

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1417956228
Phone
Not provided
Address
PO BOX 1686
Deactivation Date
13 October 2023

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
0042373953
Professional Enrollment ID
I20111222000220
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 1686

    ARDMORE, OK 734021686

    Phone:

    Type: Mailing

  • 29, North Commerce Street, Ardmore, Carter County, Oklahoma, 73401, United States

    ARDMORE, OK 734013903

    Phone: (580) 223-1925

    Fax: (580) 223-8167

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes77466$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes54247$0
97140Therapy procedure using manual technique, each 15 minutes48252$0
97530Therapy procedure using functional activities23539$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care11626$0
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Insurance plans in this area (ZIP 73402)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYOK97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes86684

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1417956228 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Physical Therapist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Oklahoma?
You will see Ardmore, Oklahoma on file for Unknown Individual alongside any extra practice locations.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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