Kylie Brynne Meerholz, M.S, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4595 Issued in OK

Practice address

11708 S Forest Ave
Jenks, OK 74037-5019

Phone

(918) 633-1184

NPI assigned

Jun 24, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in OK

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  OK

  Medicare reassignment

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1629647565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11708 S FOREST AVE",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375019",
            "telephone_number": "918-633-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11708 S FOREST AVE",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375019",
            "telephone_number": "918-633-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEERHOLZ",
        "first_name": "KYLIE",
        "middle_name": "BRYNNE",
        "credential": "M.S, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Lyn McLain, CCC-SLP
• Abby Rae McNeely, OTR/L
• Mco Peds PLLC
• Gretchen Abigail Pearl McPherson
• Taylor Christine Medina, FNP-C, FNP-BC
• Melinda Dandridge DO PLLC
• Alexandra Metcalf
• Kristen Mikes
• Cara Michelle Milam, MS CCC SLP
• Cari Ann Miller

• Speech-Language Pathologist in Jenks, OK
• Providers in Jenks, 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 Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.