Individual provider Active NPI

Whitney Kaelin Fairsheets, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1255770574
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3859 Issued in OK
Practice address
4101 NW 122ND St Ste C
Oklahoma City, OK 73120-8816
Phone
(405) 562-9260
Fax
(405) 260-9559
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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 3859 OK Primary

Addresses

Primary practice location

4101 NW 122ND St Ste C
Oklahoma City, OK 73120-8816

Mailing address

2417 NW 186TH St
Edmond, OK 73012-7663
Phone (405) 509-4168

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

LicenseStateTypeSpecialty
3859OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1255770574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 NW 186TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127663",
            "telephone_number": "405-509-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 122ND ST STE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208816",
            "telephone_number": "405-562-9260",
            "fax_number": "405-260-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRSHEETS",
        "first_name": "WHITNEY",
        "middle_name": "KAELIN",
        "name_prefix": "Mrs.",
        "credential": "M.S.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3859",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 19, 2013; 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.