Individual provider Active NPI

Caley Rose Janzen, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Tahlequah, OK
National Provider Identifier
1285161067
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4705 Issued in OK
Practice address
1607 S Muskogee Ave Ste B
Tahlequah, OK 74464-5440
Phone
(918) 458-1883
Fax
(918) 458-6331
NPI assigned
May 11, 2017
Last updated
May 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 4705 OK Primary

Addresses

Primary practice location

1607 S Muskogee Ave Ste B
Tahlequah, OK 74464-5440

Mailing address

1607 S Muskogee Ave Ste B
Tahlequah, OK 74464-5440
Phone (918) 458-1883

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4705OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1285161067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 S MUSKOGEE AVE STE B",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645440",
            "telephone_number": "918-458-1883",
            "fax_number": "918-458-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 S MUSKOGEE AVE STE B",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645440",
            "telephone_number": "918-458-1883",
            "fax_number": "918-458-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANZEN",
        "first_name": "CALEY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.

Verify at the official NPI Registry.