Active NPI
Gynna Elise Thompson, M.A. CCC-SLP
- Speech-Language Pathologist
- Grove, OK
National Provider Identifier
1013127844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1056
- Practice address
- 310 S Broadway St
Grove, OK 74344-3310 - Phone
- (918) 786-3003
- Fax
- (918) 787-2004
- NPI assigned
- May 23, 2007
- 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 | 1056 | OK | Primary |
Addresses
Primary practice location
310 S Broadway St
Grove, OK 74344-3310
Mailing address
PO Box 450789
Grove, OK 74345-0789
Phone (918) 786-3003
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1056 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1013127844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 450789",
"city": "GROVE",
"state": "OK",
"postal_code": "743450789",
"telephone_number": "918-786-3003",
"fax_number": "918-787-2004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 S BROADWAY ST",
"city": "GROVE",
"state": "OK",
"postal_code": "743443310",
"telephone_number": "918-786-3003",
"fax_number": "918-787-2004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "GYNNA",
"middle_name": "ELISE",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "1056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grove, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.