Freeborn Dysphagia Associates, LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

FREEBORN DYSPHAGIA ASSOCIATES, LLC

Doing business as

Heart of Oklahoma Center for Swallow & Speech Services

Practice address

120 S Lester Lane
Purcell, OK 73080-5451

Phone

(405) 766-1238

Fax

(405) 310-0679

NPI assigned

Nov 5, 2019

Last updated

Jun 28, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristina Alycia Freeborn, MA CCC SLPNPI 1871915462

Title

Ceo/ Owner

Phone

(405) 609-4618

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Heart of Oklahoma Center for Swallow & Speech Services Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristina Alycia Freeborn, MA. CCC-SLP

  • Speech-Language Pathologist
  • Purcell, OK
  • NPI 1871915462
  Medicare reassignment Care Compare group NPD Authorized official
• Alesa Deon McPhail, MS CCC SLP

  • Speech-Language Pathologist
  • Purcell, OK
  • NPI 1265952147
  Medicare reassignment Care Compare group NPD
• Autum Looney, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Purcell, OK
  • NPI 1114623998
  NPD
• Amanda Lee-Wray Turner, MS, CCC-SLP

  • Speech-Language Pathologist
  • Purcell, OK
  • NPI 1881458511

  Single Specialty

  NPD
• Michaela Elaine Rolph, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Dewey, OK
  • NPI 1821732389
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1043854706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18550 144TH ST",
            "city": "LEXINGTON",
            "state": "OK",
            "postal_code": "730516803",
            "telephone_number": "405-766-1238",
            "fax_number": "405-310-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S LESTER LANE",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730805451",
            "telephone_number": "405-766-1238",
            "fax_number": "405-310-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEBORN DYSPHAGIA ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A",
        "authorized_official_last_name": "FREEBORN",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "ALYCIA",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "405-609-4618",
        "authorized_official_credential": "MA CCC SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200952980A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA SLP",
            "identifier": "4171",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14002787",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE LICENSE",
            "identifier": "19013",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart of Oklahoma Center for Swallow & Speech Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• D. Bryan Dye, M.D.
• Eva Hartley LPC Ladc PLLC
• Lauren Olivia Evans, LCSW
• Alliza Angeline Fitzgibbons
• Jadyn Flores Flores Montgomery
• Kristina Alycia Freeborn, MA. CCC-SLP
• Courtney Rae Gasaway, PHARM.D.
• Bobby F Gee, DPH
• Glenn a Mead DDS PC
• Jeremy Doug Gray

• Hearing and Speech Clinic/Center in Purcell, OK
• Providers in Purcell, OK by specialty
• Hearing and Speech Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.