Active NPI
Brooke Pregler Klintworth, CCC-SLP
- Speech-Language Pathologist
- Jenks, OK
National Provider Identifier
1255579603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2771
- Practice address
- 12428 S 4TH St
Jenks, OK 74037-1077 - Phone
- (918) 809-0300
- NPI assigned
- Jan 22, 2009
- 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 | 2771 | OK | Primary |
Addresses
Primary practice location
12428 S 4TH St
Jenks, OK 74037-1077
Mailing address
PO Box 1336
Jenks, OK 74037-1336
Phone (918) 809-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200045120A | Medicaid | OK |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Therapy Services Inc | 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.
-
dba Tulsa Sunshine Center
- Multi-Specialty Clinic/Center
- Broken Arrow, OK
- NPI 1932344835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232582400000",
"number": "1255579603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1336",
"city": "JENKS",
"state": "OK",
"postal_code": "740371336",
"telephone_number": "918-809-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12428 S 4TH ST",
"city": "JENKS",
"state": "OK",
"postal_code": "740371077",
"telephone_number": "918-809-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLINTWORTH",
"first_name": "BROOKE",
"middle_name": "PREGLER",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2009-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200045120A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jenks, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.