Elizabeth Gannon, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3298 Issued in OK

Practice address

915 10TH Ave NW
Ardmore, OK 73401-4025

Phone

(580) 226-5566

Fax

(580) 226-5567

NPI assigned

May 21, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summit Rehab LLC

  • Physical Therapist
  • Madill, OK
  • NPI 1447480082

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274400000000",
    "number": "1629397252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 4TH AVE NW # 296",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 10TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734014025",
            "telephone_number": "580-226-5566",
            "fax_number": "580-226-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "ELIZABETH",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Galles-Long, D.C.
• Patrick Michael Galles, D.C.
• Harry Galoob, M.D.
• Pamela Denise Gamble
• Mackey Andrews Gammill
• Trista Deeann Gannon
• Janette Garcia-Perez
• Samantha Lea Garrett
• Anthony Michael Garringer
• Kaleigh Gary

• Speech-Language Pathologist in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.