Individual provider Active NPI

Holly Marie Richison, M.S CFY-SLP

  • Speech-Language Pathologist
  • Midwest City, OK
National Provider Identifier
1104221670
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#2161 Issued in OK
Practice address
11505 Sheffield St
Midwest City, OK 73130-8208
Phone
(405) 413-3337
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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 SP#2161 OK Primary

Addresses

Primary practice location

11505 Sheffield St
Midwest City, OK 73130-8208

Mailing address

11505 Sheffield St
Midwest City, OK 73130-8208
Phone (405) 413-3337

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 Science

State licenses

LicenseStateTypeSpecialty
SP#2161OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1104221670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 SHEFFIELD ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731308208",
            "telephone_number": "405-413-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 SHEFFIELD ST",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731308208",
            "telephone_number": "405-413-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHISON",
        "first_name": "HOLLY",
        "middle_name": "MARIE",
        "credential": "M.S CFY-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "SP#2161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midwest City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.