Active NPI
Christina Clark
- Speech-Language Pathologist
- Tulsa, OK
National Provider Identifier
1003441759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5273
- Practice address
- 6715 E 41St St
Tulsa, OK 74145-4520 - Phone
- (918) 630-3083
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5273 | OK | Primary |
Addresses
Primary practice location
6715 E 41St St
Tulsa, OK 74145-4520
Mailing address
4928 S Narcissus Ave
Broken Arrow, OK 74011-4217
Phone (918) 639-3083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5273 | OK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1003441759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4928 S NARCISSUS AVE",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740114217",
"telephone_number": "918-639-3083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6715 E 41ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741454520",
"telephone_number": "918-630-3083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHRISTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "5273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.