Healthcare Provider Details

I. General information

NPI: 1629992987
Provider Name (Legal Business Name): NEXUS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12928 N MAY AVE
OKLAHOMA CITY OK
73120-0817
US

IV. Provider business mailing address

612 CROWN STREET 615
BROOKLYN NY
11213
US

V. Phone/Fax

Practice location:
  • Phone: 347-225-1921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEVI SIMPSON
Title or Position: OWNER
Credential:
Phone: 347-225-1921