Active NPI
Jessica Green, SLP
- Speech-Language Pathologist
- Tulsa, OK
National Provider Identifier
1669610069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3470
- Practice address
- 6161 S 33Rd West Ave Ste 105
Tulsa, OK 74132-1502 - Phone
- (918) 698-5561
- Fax
- (918) 398-7983
- NPI assigned
- Jan 23, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3470 | OK | Primary |
Addresses
Primary practice location
6161 S 33Rd West Ave Ste 105
Tulsa, OK 74132-1502
Mailing address
6161 S 33Rd West Ave Ste 105
Tulsa, OK 74132-1502
Phone (918) 698-5561
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3470 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Therapy Services Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Broken Arrow, OK
- NPI 1932344835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1669610069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6161 S 33RD WEST AVE STE 105",
"city": "TULSA",
"state": "OK",
"postal_code": "741321502",
"telephone_number": "918-698-5561",
"fax_number": "918-398-7983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6161 S 33RD WEST AVE STE 105",
"city": "TULSA",
"state": "OK",
"postal_code": "741321502",
"telephone_number": "918-698-5561",
"fax_number": "918-398-7983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JESSICA",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-23",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "3470",
"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 Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.