Individual provider Active NPI

Tracy Goebel, M.ED.,CCC,SLP

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1205090032
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2785 Issued in OK
Practice address
10020 Mahler PL
Oklahoma City, OK 73120-3312
Phone
(405) 413-3397
Fax
(405) 607-0452
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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 2785 OK Primary

Addresses

Primary practice location

10020 Mahler PL
Oklahoma City, OK 73120-3312

Mailing address

10020 Mahler PL
Oklahoma City, OK 73120-3312
Phone (405) 413-3397

Other identifiers 1

IdentifierTypeStateIssuer
200086540AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180123001206 OK Practitioner - Qualified Speech Language Pathologist 5193084085 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2785OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 2, 2018 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jan 2, 2018 Accepting new patients
Effective Communication LLC Speech-Language Pathologist Past Accepting new patients

Locations

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

1100 NE 13th St
Oklahoma City, OK 73117
Phone (405) 271-5700

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 5

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1205090032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 MAHLER PL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731203312",
            "telephone_number": "405-413-3397",
            "fax_number": "405-607-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 MAHLER PL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731203312",
            "telephone_number": "405-413-3397",
            "fax_number": "405-607-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEBEL",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "M.ED.,CCC,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200086540A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.