Active NPI
Sandra Marie Holmes, M.ED., CCC-SLP
- Speech-Language Pathologist
- Stilwell, OK
National Provider Identifier
1356789838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2048
- Practice address
- 100 Maryetta Road
Stilwell, OK 74960 - Phone
- (918) 696-2285
- Fax
- (918) 696-6746
- NPI assigned
- Jun 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2048 | OK | Primary |
Addresses
Primary practice location
100 Maryetta Road
Stilwell, OK 74960
Mailing address
15803 West 811 Road
Tahlequah, OK 74464
Phone (918) 822-3945
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2048 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370476800000",
"number": "1356789838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15803 WEST 811 ROAD",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "74464",
"telephone_number": "918-822-3945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARYETTA ROAD",
"city": "STILWELL",
"state": "OK",
"postal_code": "74960",
"telephone_number": "918-696-2285",
"fax_number": "918-696-6746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "SANDRA",
"middle_name": "MARIE",
"credential": "M.ED., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-06",
"last_updated": "2013-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stilwell, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.