Individual provider Active NPI

Tracey Lynn Stiller, MS - SLP

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1124424486
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4311 Issued in OK
Practice address
7608 E 91St St
Tulsa, OK 74133-6014
Phone
(918) 663-0606
Fax
(918) 663-8754
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 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 4311 OK Primary

Addresses

Primary practice location

7608 E 91St St
Tulsa, OK 74133-6014

Mailing address

7608 E 91St St
Tulsa, OK 74133-6014
Phone (918) 663-0606

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
4311OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Works Inc Speech-Language Pathologist 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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1124424486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7608 E 91ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336014",
            "telephone_number": "918-663-0606",
            "fax_number": "918-663-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7608 E 91ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336014",
            "telephone_number": "918-663-0606",
            "fax_number": "918-663-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLER",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MS - SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.