OrganizationActive
Fundamental Physical Therapy PLLC
NPI 1215266671 · Physical Therapy Clinic/Center · Edmond, OK
Provider details
- NPI number
- 1215266671
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Debra Clark, Owner(405) 513-8118
- License
- 821 (OK)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3500 S Boulevard
Suite A1
Edmond, OK 73013-5486
Phone: (405) 518-8118
Street-level locationGet directions
Mailing address
Po Box 3542
Edmond, OK 73083-3542
Registry dates
- Enumerated
- 2009-12-15
- Last updated
- 2015-09-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.