Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Glenn Berry

Individual provider Physical Therapist · NPI 1376878108

Glenn Berry is a Physical Therapist in Private Practice in Ada, Oklahoma. Qualified in 2009, 17 years ago. Practices with Chickasaw Nation Division of Health, a 243-clinician group and accepts Medicare assignment. Licensed in Missouri and Oklahoma.

Years since qualifying
17
Licensed in
MO, OK
In the registry since
2009
Specialties on file
2
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Practice location Address checks out

1921 Stonecipher Blvd
Ada, OK 74820
Phone: (580) 436-3980
Fax: (580) 421-6283
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 4288 (OK)
Physical Therapist Taxonomy 225100000X · Licence 2009025549 (MO)

Record details

NPI number1376878108
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2009
Last updated in NPPESJuly 9, 2015
Mailing address1921 Stonecipher Blvd, Ada, OK 74820

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Chickasaw Nation Division Of Health — 243 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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