Individual provider Active NPI

Elizabeth Ann Wann, M.ED CCC-SLP

  • Speech-Language Pathologist
  • Poteau, OK
National Provider Identifier
1669851689
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2007 Issued in OK
Practice address
35040 Midway Rd
Poteau, OK 74953-7464
Phone
(918) 658-8481
NPI assigned
May 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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 2007 OK Primary

Addresses

Primary practice location

35040 Midway Rd
Poteau, OK 74953-7464

Mailing address

35040 Midway Rd
Poteau, OK 74953-7464
Phone (918) 658-8481

Other identifiers 1

IdentifierTypeStateIssuer
2007OtherOKOKLAHOMA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY

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": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1669851689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35040 MIDWAY RD",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749537464",
            "telephone_number": "918-658-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35040 MIDWAY RD",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749537464",
            "telephone_number": "918-658-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.ED CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY",
            "identifier": "2007",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poteau, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.