Individual provider Active NPI

Jorah Kotary, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1366910242
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14196177 Issued in OK
Practice address
1500 SW 104TH St Ste 102
Oklahoma City, OK 73159-7661
Phone
(405) 735-6222
NPI assigned
Nov 8, 2018
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 14196177 OK Primary

Addresses

Primary practice location

1500 SW 104TH St Ste 102
Oklahoma City, OK 73159-7661

Mailing address

1500 SW 104TH St Ste 102
Oklahoma City, OK 73159-7661
Phone (405) 735-6222

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 Science

State licenses

LicenseStateTypeSpecialty
14196177OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1366910242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SW 104TH ST STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597661",
            "telephone_number": "405-735-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SW 104TH ST STE 102",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597661",
            "telephone_number": "405-735-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTARY",
        "first_name": "JORAH",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "14196177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 8, 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.

Verify at the official NPI Registry.