Individual provider Active NPI

Leigh D Skomolo, MA.CCC-SLP

  • Speech-Language Pathologist
  • Norman, OK
National Provider Identifier
1104053909
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5318 Issued in OK
Practice address
2405 Palmer Cir Ste 100
Norman, OK 73069-6351
Phone
(405) 561-7928
Fax
(405) 310-9944
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 5318 OK Primary

Addresses

Primary practice location

2405 Palmer Cir Ste 100
Norman, OK 73069-6351

Mailing address

2405 Palmer Cir Ste 100
Norman, OK 73069-6351
Phone (405) 561-7928

Other identifiers 1

IdentifierTypeStateIssuer
200924500AMedicaidOK

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5318OKMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1104053909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 PALMER CIR STE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696351",
            "telephone_number": "405-561-7928",
            "fax_number": "405-310-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 PALMER CIR STE 100",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696351",
            "telephone_number": "405-561-7928",
            "fax_number": "405-310-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOMOLO",
        "first_name": "LEIGH",
        "middle_name": "D",
        "credential": "MA.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "5318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200924500A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.