Active NPI
Edith Ann Young, MA CCC SLP
- Speech-Language Pathologist
- Oklahoma City, OK
National Provider Identifier
1366534380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12875
- Practice address
- 9900 Broadway Ext Ste 200
Oklahoma City, OK 73114-6323 - Phone
- (972) 937-8255
- Fax
- (972) 937-8504
- NPI assigned
- Sep 28, 2006
- 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 | 12875 | TX | Primary |
Addresses
Primary practice location
9900 Broadway Ext Ste 200
Oklahoma City, OK 73114-6323
Mailing address
13508 Borgata LN
Oklahoma City, OK 73170-2056
Phone (214) 415-1756
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7822 | Other | TX | PARKLAND HEALTHPLAN CHIP |
| 7879125 | Other | TX | AETNA PPO |
| 528410 | Other | TX | BLUE CROSS BLUE SHIELD |
| 2367715 | Other | TX | AETNA HMO |
Other names 1
- Edith Ann McCollom
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543276800000",
"number": "1366534380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13508 BORGATA LN",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731702056",
"telephone_number": "214-415-1756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 BROADWAY EXT STE 200",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731146323",
"telephone_number": "972-937-8255",
"fax_number": "972-937-8504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "EDITH",
"middle_name": "ANN",
"credential": "MA CCC SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2018-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "12875",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARKLAND HEALTHPLAN CHIP",
"identifier": "7822",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "7879125",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "528410",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2367715",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EDITH",
"last_name": "MCCOLLOM",
"middle_name": "ANN",
"credential": "MA CCC SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.