Active NPI
Monica Dawn Judy, M.S CCC-SLP
- Speech-Language Pathologist
- Broken Arrow, OK
National Provider Identifier
1508057498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3116
- Practice address
- 2208 W Detroit St Ste 101
Broken Arrow, OK 74012-3630 - Phone
- (918) 806-0106
- Fax
- (918) 806-0113
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 3116 | OK | Primary |
Addresses
Primary practice location
2208 W Detroit St Ste 101
Broken Arrow, OK 74012-3630
Mailing address
24935 Ky Ave
Claremore, OK 74019-4348
Phone (918) 706-4140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200049340A | Medicaid | OK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262822400000",
"number": "1508057498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24935 KY AVE",
"city": "CLAREMORE",
"state": "OK",
"postal_code": "740194348",
"telephone_number": "918-706-4140",
"fax_number": "918-343-9469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2208 W DETROIT ST STE 101",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740123630",
"telephone_number": "918-806-0106",
"fax_number": "918-806-0113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDY",
"first_name": "MONICA",
"middle_name": "DAWN",
"credential": "M.S CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2010-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "3116",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200049340A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.