Individual provider Active NPI

Melissa Kay Longhurst, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Yukon, OK
National Provider Identifier
1093007676
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1770 Issued in NV
Practice address
4301 N Sara Rd Ste 120
Yukon, OK 73099-3682
Phone
(405) 982-2086
Fax
(405) 900-4062
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1770 NV Primary

Addresses

Primary practice location

4301 N Sara Rd Ste 120
Yukon, OK 73099-3682

Mailing address

4301 N Sara Rd Ste 120
Yukon, OK 73099-3682
Phone (405) 328-8781

Other practice location 1

8313 Fritzen Ave
Las Vegas, NV 89131-4608
Phone (702) 861-5005

Other identifiers 1

IdentifierTypeStateIssuer
12116391OtherASHA NUMBER

Other names 1

  • Melissa Kay Allsbrook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200326002592 NV Practitioner - Qualified Speech Language Pathologist 9335578376 Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP1770NVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech by Melissa LLC Speech-Language Pathologist CurrentSince Mar 29, 2020 Accepting new patients

Locations

4301 N Sara Rd
Ste 120
Yukon, OK 73099
Phone (405) 982-2086

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1093007676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 N SARA RD STE 120",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993682",
            "telephone_number": "405-328-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 N SARA RD STE 120",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993682",
            "telephone_number": "405-982-2086",
            "fax_number": "405-900-4062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8313 FRITZEN AVE",
            "address_purpose": "LOCATION",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891314608",
            "country_code": "US",
            "telephone_number": "702-861-5005",
            "fax_number": "702-952-0437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGHURST",
        "first_name": "MELISSA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP1770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA NUMBER",
            "identifier": "12116391",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "ALLSBROOK",
            "middle_name": "KAY",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.