Active NPI
Lori Ann Tydings
- Speech-Language Pathologist
- Enid, OK
National Provider Identifier
1114501863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2080
- Practice address
- 2102 Beverly Dr
Enid, OK 73703-7654 - Phone
- (580) 366-7650
- NPI assigned
- May 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2080 | OK | Primary |
Addresses
Primary practice location
2102 Beverly Dr
Enid, OK 73703-7654
Mailing address
2414 S Imo Rd
Enid, OK 73703-7209
Phone (580) 554-9791
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2080 | Medicaid | OK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2080 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1114501863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2414 S IMO RD",
"city": "ENID",
"state": "OK",
"postal_code": "737037209",
"telephone_number": "580-554-9791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 BEVERLY DR",
"city": "ENID",
"state": "OK",
"postal_code": "737037654",
"telephone_number": "580-366-7650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYDINGS",
"first_name": "LORI",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-10",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2080",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2080",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.