Individual provider Active NPI

Melissa Lewis, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Norman, OK
National Provider Identifier
1104216100
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5172 Issued in OK
Practice address
2429 Westport Dr
Norman, OK 73069-6337
Phone
(405) 314-9345
NPI assigned
Jan 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X T86 AK
Speech-Language Pathologist 235Z00000X 5172 OK Primary

Addresses

Primary practice location

2429 Westport Dr
Norman, OK 73069-6337

Mailing address

2429 Westport Dr
Norman, OK 73069-6337

Other practice location 1

4600 Business Park Blvd Ste D-24
Anchorage, AK 99503-7142
Phone (907) 561-1478

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

LicenseStateTypeSpecialty
T86AKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Pediatric Therapy Past Accepting new patients

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": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1104216100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 WESTPORT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 WESTPORT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696337",
            "telephone_number": "405-314-9345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Business Park Blvd Ste D-24",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995037142",
            "country_code": "US",
            "telephone_number": "907-561-1478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MELISSA",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "T86",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "5172",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 25, 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.

Verify at the official NPI Registry.