SHEPHERD MALL THERAPY LLC


Address: 2401 Nw 23rd St Ste 2d, Oklahoma City, OK 73107-2420
Phone: 4053553239

SHEPHERD MALL THERAPY LLC (NPI# 1285136135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285136135
Entity Type Organization
Organization Name SHEPHERD MALL THERAPY LLC
Practice Address 2401 Nw 23rd St Ste 2d
Oklahoma City
OK 73107-2420
Mailing Address 4334 Nw Expressway Ste 187
Oklahoma City
OK 73116-1515
Practice Telephone 4053553239
Practice Fax Number 4052124270
Mailing Fax Number 4052124270
Enumeration Date 2018-03-07
Last Update Date 2018-03-07
Authorized Official Name DOUGLAS EDWIN BROWN JR. (PRESIDENT)
Authorized Official Telephone 4053553239
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QH0700X Clinic/Center
Specialization: Hearing and Speech
Ambulatory Health Care Facilities
N 261QX0100X Clinic/Center
Specialization: Occupational Medicine
Ambulatory Health Care Facilities
Y 261QP2000X Clinic/Center
Specialization: Physical Therapy
Ambulatory Health Care Facilities

Office Location

Street Address 2401 NW 23RD ST STE 2D
City OKLAHOMA CITY
State OK
Zip Code 73107-2420

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154921062 Erin Bieler Speech-Language Pathologist 2401 Nw 23rd St Ste 2d, Oklahoma City, OK 73107-2420 2020-10-29
1952924490 Kamree Wackler Speech-Language Pathologist 2401 Nw 23rd St Ste 2d, Oklahoma City, OK 73107-2420 2020-05-19
1548804339 Reagan Minefee Speech-Language Pathologist 2401 Nw 23rd St Ste 2d, Oklahoma City, OK 73107-2420 2019-11-05
1457918252 Annelise Luddington Speech-Language Pathologist 2401 Nw 23rd St Ste 2d, Oklahoma City, OK 73107-2420 2019-05-28
1144710062 Maryorie Montalvo Speech-Language Pathologist 2401 Nw 23rd St Ste 2d, Oklahoma City, OK 73107-2420 2018-05-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144747999 Ellen Rose Pochyly Counselor 2617 General Pershing Boulevard, Oklahoma City, OK 73107 2017-08-23
1609399906 Carrie Ann Moore Counselor 2617 General Pershing Blvd., Oklahoma City, OK 73107 2017-07-19
1821511320 Diana Lynn Spencer Counselor 2617generalpershingblvd, Oklahoma City, OK 73107 2017-07-18
1861859514 Catherine Evans Counselor 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 2016-01-26
1871964551 Kizzy Frazier Student in an Organized Health Care Education/Training Program 1233 N Warren Pl, Oklahoma City, OK 73107 2015-10-07
1538550629 Oklahoma Department of Mental Health and Substance Abuse Case Management 2625 General Pershing Boulevard, Oklahoma City, OK 73107 2015-02-10
1952702276 Andale Healthcare, LLC Clinic/Center 2305 N. Meridian, Oklahoma City, OK 73107 2014-09-05
1114339348 John Walls Psychologist 2012 North Villa Avenue, Oklahoma City, OK 73107 2014-05-22
1376970517 Latrice Warrior Community/Behavioral Health 2625 General Pershing Drive, Oklahoma City, OK 73107 2013-10-02
1326485541 Debra Sue Vaughan Counselor 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 2013-05-29
Find all providers in zip 73107

Taxonomy Information

Taxonomy Code 261QP2000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Physical Therapy

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144821604 Body Smart Physio LLC Clinic/Center 1745a Nw 16th St Ste A, Oklahoma City, OK 73106-2067 2020-11-02
1497371322 Leah Diane Spurlock Clinic/Center 429 W Wilshire Blvd Ste B, Oklahoma City, OK 73116-7745 2020-06-16
1134781677 Peak Solutions, LLC Clinic/Center 12401 Trail Oaks Drive, Therapy Room, 2nd Floor, Oklahoma City, OK 73120 2019-07-05
1851854368 Physical Therapy Services, LLC Clinic/Center 200 N Classen Blvd, Oklahoma City, OK 73106-7627 2019-04-11
1235658261 Heinen Physical Therapy, PC Clinic/Center 7710 N May Ave, Oklahoma City, OK 73116 2017-09-11
1841659463 Peak Solutions, LLC Clinic/Center 9400 N Broadway, Suite 120, Oklahoma City, OK 73114-7451 2016-02-11
1548538655 Functional Performance Training and Physical Therapy, Pllc Clinic/Center 13512 N Eastern Ave, Suite A, Oklahoma City, OK 73131-1812 2011-12-02
1881998870 Performax Therapy Services Clinic/Center 4334 Nw Expressway Ste 176, Oklahoma City, OK 73116-1550 2011-01-05
1750691226 Five Star Physical Therapy and Sport Medicine, LLC Clinic/Center 6801 Norht Classen Blvd., Suite #b, Oklahoma City, OK 73116 2010-10-18
1073777991 Rehabsource-therapy At Work, LLC Clinic/Center 4141 Nw Expressway Ste 325, Oklahoma City, OK 73116-1675 2008-07-10
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Competitor

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City OKLAHOMA CITY
Zip Code 73107

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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