NPIMap

Organization Active NPI

Supplemental Healthcare

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1568759587
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3524 Issued in OK
Legal business name
SUPPLEMENTAL HEALTHCARE
Practice address
3030 NW Expressway
Suite #809
Oklahoma City, OK 73112-5474
Phone
(405) 917-7160
NPI assigned
Jun 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Aj Whitley
Title
Staffing Manager
Phone
(405) 917-7160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 3524 OK Primary

Addresses

Primary practice location

3030 NW Expressway
Suite #809
Oklahoma City, OK 73112-5474

Mailing address

3030 NW Expressway
Suite #809
Oklahoma City, OK 73112-5474

National Provider Directory

National Provider Directory
Tax ID family
Supplemental42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

3030 NW Expressway St
Ste 809
Oklahoma City, OK 73112
Phone (405) 917-7160

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1568759587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 NW EXPRESSWAY",
            "address_2": "SUITE #809",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NW EXPRESSWAY",
            "address_2": "SUITE #809",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125474",
            "telephone_number": "405-917-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "WHITLEY",
        "authorized_official_first_name": "AJ",
        "authorized_official_title_or_position": "STAFFING MANAGER",
        "authorized_official_telephone_number": "405-917-7160"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3524",
            "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 Jun 29, 2011; 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.