Individual provider Active NPI

Sally Ann Rauch, CCCSLP

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1629309216
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2200 Issued in OK
Practice address
2425 S Memorial Dr
Tulsa, OK 74129-2617
Phone
(918) 628-0932
NPI assigned
Jan 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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 2200 OK Primary

Addresses

Primary practice location

2425 S Memorial Dr
Tulsa, OK 74129-2617

Mailing address

1709 N Kingston PL
Tulsa, OK 74115-4415
Phone (918) 671-6314

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

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1629309216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 N KINGSTON PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741154415",
            "telephone_number": "918-671-6314",
            "fax_number": "918-834-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741292617",
            "telephone_number": "918-628-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "CCCSLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 20, 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.

Verify at the official NPI Registry.