Prohab Therapy Specialists – Physical Therapist, NPI 1447480082
Physical Therapist
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Prohab Therapy Specialists
410 W LILLIE BLVD
MADILL, OK 734461270
Phone: (580) 872-4277
Fax: (580) 872-4261
Type: Location
1107 W Broadway St
Ardmore, OK 734012833
Phone: (580) 226-5566
Fax: (580) 226-5567
Type: Location
7715 E 111th St Ste 111
Tulsa, OK 741332572
Phone: (918) 891-3424
Fax: (918) 891-3776
Type: Location
307 4th Ave SE
Ardmore, OK 734018216
Phone: (580) 226-5566
Fax: (580) 226-5567
Type: Location
1405, 4th Avenue Northwest, Ardmore, Carter County, Oklahoma, 73401, United States
#296
ARDMORE, OK 73401
Phone:
Type: Mailing
1107, West Broadway Street, Ardmore, Carter County, Oklahoma, 73401, United States
ARDMORE, OK 734012833
Phone: (580) 226-5566
Fax: (580) 226-5567
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: 2009-12-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20091222000314 | O | Clinic/Group Practice | OK | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 73446)
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