Active NPI
Marjorie Evilsizer, MS, CCC-SLP
- Speech-Language Pathologist
- Yukon, OK
National Provider Identifier
1669955126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1010
- Practice address
- 11205 NW 113TH St
Yukon, OK 73099-8040 - Phone
- (405) 306-7067
- NPI assigned
- Sep 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 1010 | OK | Primary |
Addresses
Primary practice location
11205 NW 113TH St
Yukon, OK 73099-8040
Mailing address
11205 NW 113TH St
Yukon, OK 73099-8040
Phone (405) 306-7067
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1010 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536624000000",
"number": "1669955126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11205 NW 113TH ST",
"city": "YUKON",
"state": "OK",
"postal_code": "730998040",
"telephone_number": "405-306-7067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11205 NW 113TH ST",
"city": "YUKON",
"state": "OK",
"postal_code": "730998040",
"telephone_number": "405-306-7067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVILSIZER",
"first_name": "MARJORIE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-11",
"last_updated": "2018-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "1010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yukon, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.