MRS. KIMBERLY ROSE EDWARDS (PT, DPT) – Physical Therapist, NPI 1710135330

MRS. KIMBERLY ROSE EDWARDS (PT, DPT) is a healthcare provider. based in Tahlequah, Oklahoma. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 5094 (OK). The NPI Number for MRS. KIMBERLY ROSE EDWARDS (PT, DPT) is 1710135330

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY ROSE EDWARDS (PT, DPT)
NPI
1710135330
Phone
(918) 458-9235
Address
409 DAISY DR
Enumeration Date
8 September 2008
Last Update Date
27 June 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4795243378
Graduation Year
2008 (18 years ago)
PAC ID
8224199849
Group Practice PAC ID
4789686486
Professional Enrollment ID
I20170503001941
Address ID
AR727615585SI2021XMAIN401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

845 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OK

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Provider Addresses for MRS. KIMBERLY ROSE EDWARDS (PT, DPT)

  • 409 DAISY DR

    STE F-2

    TAHLEQUAH, OK 744647410

    Phone: (918) 458-9235

    Fax: (918) 458-9236

    Type: Mailing

  • West Houston Street, Broken Arrow, Tulsa County, Oklahoma, 74012, United States

    BROKEN ARROW, OK 740123519

    Phone: (918) 259-1888

    Fax: (918) 251-3725

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-05-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170503001941IPhysical Therapist In Private PracticeARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 minutes29624$0
97140Therapy procedure using manual technique, each 15 minutes22721$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care15120$0
97530Therapy procedure using functional activities10012$0
97161Evaluation for physical therapy, typically 20 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 74464)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789686486View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeCO

Reviews

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Frequently asked questions

What NPI should I save for MRS. KIMBERLY ROSE EDWARDS (PT, DPT)?
Save NPI 1710135330 if you need a stable reference for MRS. KIMBERLY ROSE EDWARDS (PT, DPT).
Is MRS. KIMBERLY ROSE EDWARDS (PT, DPT) active in the national directory?
MRS. KIMBERLY ROSE EDWARDS (PT, DPT)'s public NPI profile is in an active state.
What does MRS. KIMBERLY ROSE EDWARDS (PT, DPT) treat or focus on?
Patients typically see MRS. KIMBERLY ROSE EDWARDS (PT, DPT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Does MRS. KIMBERLY ROSE EDWARDS (PT, DPT) practice in Oklahoma?
You will see Tahlequah, Oklahoma on file for MRS. KIMBERLY ROSE EDWARDS (PT, DPT) alongside any extra practice locations.
What if Tahlequah, Oklahoma seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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