Individual provider Active NPI

Stephanie Little

  • Speech-Language Pathologist
  • Lawton, OK
National Provider Identifier
1114490513
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4690 Issued in OK
Practice address
501 SE Flower Mound Rd
Lawton, OK 73501-6388
Phone
(580) 351-6511
NPI assigned
Jan 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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 4690 OK Primary

Addresses

Primary practice location

501 SE Flower Mound Rd
Lawton, OK 73501-6388

Mailing address

906 SW 80TH St
Lawton, OK 73505-6426
Phone (580) 647-0812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200407002305 OK Practitioner - Qualified Speech Language Pathologist 7214366541 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4690OKMDMental Health Counselor

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": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1114490513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 SW 80TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056426",
            "telephone_number": "580-647-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE FLOWER MOUND RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735016388",
            "telephone_number": "580-351-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.