Organization Active NPI

Speech Pathways, PLLC

  • Rehabilitation Clinic/Center
  • Ardmore, OK
National Provider Identifier
1053361741
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SPEECH PATHWAYS, PLLC
Practice address
812 12TH Ave NW
Ardmore, OK 73401-5708
Phone
(580) 223-1313
Fax
(580) 223-1629
NPI assigned
May 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie Owen Shelton, PHD
Title
Speech Language Pathologist
Phone
(580) 223-1313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

812 12TH Ave NW
Ardmore, OK 73401-5708

Mailing address

1002 Stanley St SW
Ardmore, OK 73401-4638
Phone (580) 226-5210

Other identifiers 1

IdentifierTypeStateIssuer
441868611-001OtherOKBCBS 12 DIGIT #

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053361741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 STANLEY ST SW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734014638",
            "telephone_number": "580-226-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 12TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015708",
            "telephone_number": "580-223-1313",
            "fax_number": "580-223-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH PATHWAYS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "OWEN",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "580-223-1313",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS 12 DIGIT #",
            "identifier": "441868611-001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.