Active NPI
Carol Reggio
- Speech-Language Pathologist
- Shawnee, OK
National Provider Identifier
1164960332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2364
- Practice address
- 326 N Union Ave
Shawnee, OK 74801-7053 - Phone
- (405) 273-6794
- Fax
- (405) 878-1037
- NPI assigned
- Feb 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 2364 | OK | Primary |
Addresses
Primary practice location
326 N Union Ave
Shawnee, OK 74801-7053
Mailing address
326 N Union Ave
Shawnee, OK 74801-7053
Phone (405) 273-6794
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 |
|---|---|---|---|
| 2364 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1164960332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 N UNION AVE",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748017053",
"telephone_number": "405-273-6794",
"fax_number": "405-878-1037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 N UNION AVE",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748017053",
"telephone_number": "405-273-6794",
"fax_number": "405-878-1037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGGIO",
"first_name": "CAROL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-07",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.