Individual provider Active NPI

Avery Story, PROGRAM DIRECTOR SLP

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1508517186
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4542 Issued in OK
Practice address
6800 S Granite Ave
Tulsa, OK 74136-7039
Phone
(918) 822-2554
NPI assigned
Jan 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 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 4542 OK Primary

Addresses

Primary practice location

6800 S Granite Ave
Tulsa, OK 74136-7039

Mailing address

10619 S Nathan St
Jenks, OK 74037-1821
Phone (918) 822-2554

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL desktop Health Information Exchange (HIE)

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
4542OKMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1508517186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10619 S NATHAN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740371821",
            "telephone_number": "918-822-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 S GRANITE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367039",
            "telephone_number": "918-822-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY",
        "first_name": "AVERY",
        "credential": "PROGRAM DIRECTOR SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6800 S Granite Ave",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741367039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 14, 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.