Individual provider Active NPI

Makenzie Klewer

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1346965282
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5201 Issued in OK
Practice address
3712 E 83Rd St
Tulsa, OK 74137-1703
Phone
(918) 704-2760
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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 5201 OK Primary

Addresses

Primary practice location

3712 E 83Rd St
Tulsa, OK 74137-1703

Mailing address

5245 S Irvington PL
Tulsa, OK 74135-7515
Phone (417) 861-2577

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
5201OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Motor Mouth Therapy, LLC Speech-Language Pathologist PastSince Oct 9, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1346965282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 S IRVINGTON PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357515",
            "telephone_number": "417-861-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 E 83RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741371703",
            "telephone_number": "918-704-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEWER",
        "first_name": "MAKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "5201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.