Individual provider Active NPI

Shelly Deann Geddes, M.S.

  • Speech-Language Pathologist
  • Norman, OK
National Provider Identifier
1659580512
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3288 Issued in OK
Practice address
4331 Adams Rd Ste 111
Norman, OK 73069-1007
Phone
(405) 438-0090
Fax
(405) 493-0717
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 3288 OK Primary

Addresses

Primary practice location

4331 Adams Rd Ste 111
Norman, OK 73069-1007

Mailing address

1810 Marymount Rd
Norman, OK 73071-3948
Phone (405) 990-9417

Other practice location 1

929 E Britton Rd
Oklahoma City, OK 73114-7802
Phone (405) 438-0090

Other practice location 2

9900 Broadway Ext Ste 200
Oklahoma City, OK 73114-6323
Phone (405) 438-0090

Other identifiers 1

IdentifierTypeStateIssuer
200114180MedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000343 OK Practitioner - Qualified Speech Language Pathologist 3779739461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3288OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Communication Solutions, Inc Speech-Language Pathologist CurrentSince Nov 1, 2023 Accepting new patients

Locations

2761 Washington Dr
Ste 111
Norman, OK 73069
Phone (405) 438-0090

4331 Adams Rd
#111
Norman, OK 73069
Phone (405) 438-0090

929 E Britton Rd
Oklahoma City, OK 73114
Phone (405) 438-0090

9900 Broadway Ext
Ste 200
Oklahoma City, OK 73114
Phone (405) 608-8833

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1659580512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MARYMOUNT RD",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730713948",
            "telephone_number": "405-990-9417",
            "fax_number": "405-493-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4331 ADAMS RD STE 111",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730691007",
            "telephone_number": "405-438-0090",
            "fax_number": "405-493-0717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 E Britton Rd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731147802",
            "country_code": "US",
            "telephone_number": "405-438-0090",
            "fax_number": "405-493-0717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9900 Broadway Ext Ste 200",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731146323",
            "country_code": "US",
            "telephone_number": "405-438-0090",
            "fax_number": "405-493-0717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEDDES",
        "first_name": "SHELLY",
        "middle_name": "DEANN",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200114180",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.