Individual provider Active NPI

Susan Elizabeth Benson, PH.D.

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1609866565
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
369 Issued in OK
Practice address
1200 N Stonewall Ave
John W Keys Speech and Hearing Center
Oklahoma City, OK 73117-1215
Phone
(405) 271-4214
Fax
(405) 271-3360
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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 369 OK Primary

Addresses

Primary practice location

1200 N Stonewall Ave
John W Keys Speech and Hearing Center
Oklahoma City, OK 73117-1215

Mailing address

1200 N Stonewall Ave
John W Keys Speech and Hearing Center
Oklahoma City, OK 73104-4649
Phone (405) 271-4214

Other identifiers 1

IdentifierTypeStateIssuer
100661870AMedicaidOK

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
369OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1609866565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STONEWALL AVE",
            "address_2": "JOHN W KEYS SPEECH AND HEARING CENTER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044649",
            "telephone_number": "405-271-4214",
            "fax_number": "405-271-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STONEWALL AVE",
            "address_2": "JOHN W KEYS SPEECH AND HEARING CENTER",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171215",
            "telephone_number": "405-271-4214",
            "fax_number": "405-271-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100661870A",
            "state": "OK"
        }
    ],
    "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 Mar 12, 2009; 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.