Kathryn Bacon, M.ED. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2651 Issued in OK

Practice address

6939 S 28TH West Ave
Tulsa, OK 74132-1738

Phone

(918) 906-9751

NPI assigned

Aug 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1154875771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6939 S 28TH WEST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321738",
            "telephone_number": "918-906-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 S 28TH WEST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741321738",
            "telephone_number": "918-906-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "M.ED. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph John Back, DO
• Stephen Arthur Back, D.O.
• Chloe Backhaus-Vogt
• Shelby Lynn Backward
• Jake Curtis Bacon Sr.
• Olivia Paige Bacon
• Chloe Badertscher
• Conner Jackson Badiyan
• Angela Badsch, DO
• Joshua Baer

• All providers in Tulsa, OK
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.