Individual provider Active NPI

Weslie Aa. Elliott, M.S.

  • Speech-Language Pathologist
  • Durant, OK
National Provider Identifier
1154879815
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4353 Issued in OK
Practice address
1524 Chuckwa Dr
Durant, OK 74701-2142
Phone
(580) 924-4299
Fax
(580) 924-1651
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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 4353 OK Primary

Addresses

Primary practice location

1524 Chuckwa Dr
Durant, OK 74701-2142

Mailing address

PO Box 598
Durant, OK 74702-0598
Phone (580) 924-4299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119001528 OK Practitioner - Qualified Speech Language Pathologist 2668843129 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4353OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Janee Standifer SLP, LLC Speech-Language Pathologist CurrentSince Jan 10, 2023 Accepting new patients

Locations

1600 W University Blvd
Durant, OK 74701
Phone (580) 740-0205

1600 N Washington Ave
Durant, OK 74701
Phone (580) 740-0205

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1154879815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 598",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747020598",
            "telephone_number": "580-924-4299",
            "fax_number": "580-924-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 CHUCKWA DR",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012142",
            "telephone_number": "580-924-4299",
            "fax_number": "580-924-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "WESLIE",
        "middle_name": "AA.",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.