Individual provider Active NPI

Andrea Christine McNulty, MS, CCC-SLP

  • Speech-Language Pathologist
  • Lawton, OK
National Provider Identifier
1295454940
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4949 Issued in OK
Practice address
7102 NW Cache Rd
Lawton, OK 73505-2710
Phone
(580) 280-4651
Fax
(580) 280-4652
NPI assigned
Aug 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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 4949 OK Primary

Addresses

Primary practice location

7102 NW Cache Rd
Lawton, OK 73505-2710

Mailing address

3300 Longhorn Dr
Colonial Heights, VA 23834-1780
Phone (856) 287-7731

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912000455 OK Practitioner - Qualified Speech Language Pathologist 9436534500 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4949OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Hospital Authority CurrentSince Sep 15, 2022 Accepting new patients
Comanche County Hospital Authority CurrentSince Sep 15, 2022 Accepting new patients

Locations

5404 SW Lee Blvd
Lawton, OK 73505
Phone (580) 355-5242

7102 NW Cache Rd
Lawton, OK 73505
Phone (580) 280-4651

3811 W Gore Blvd
Lawton, OK 73505
Phone (580) 581-1500

1202 NW Arlington Ave
Lawton, OK 73507
Phone (580) 248-2288

Organizations & group practices 2

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": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1295454940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 LONGHORN DR",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341780",
            "telephone_number": "856-287-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7102 NW CACHE RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735052710",
            "telephone_number": "580-280-4651",
            "fax_number": "580-280-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "ANDREA",
        "middle_name": "CHRISTINE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.