Kaylin A Peterson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5412 Issued in OK

Practice address

3315 Kethley Rd
Shawnee, OK 74804-9638

Phone

(405) 395-3821

Fax

(405) 395-3983

NPI assigned

Nov 23, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Saints Medical Group, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437195922
  Medicare reassignment NPD
• Saints Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Edmond, OK
  • NPI 1730907700
  NPD

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1346907516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "405-395-3821",
            "fax_number": "405-395-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "405-395-3821",
            "fax_number": "405-395-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KAYLIN",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "5412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Peevy, PAC
• Lon Preston Pennington, D.PH.
• Pamela York Pensoneau
• Anna Marie Perdue, M.ED.
• Michelle K Peters
• Marianna Kay-Araceli Pettyjohn
• Dianna Lynn Pharaoh, LPC
• Pharm Shawnee Acquisition LLC
• Pharm Shawnee Acquisition LLC
• Jackson Davis Phelps, LPN

• Speech-Language Pathologist in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.