Individual provider Active NPI

Teresa Sheerilee Hurst, CCC-SLP

  • Speech-Language Pathologist
  • Altus, OK
National Provider Identifier
1679092969
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2130 Issued in OK
Practice address
1200 E Pecan St
Altus, OK 73521-6141
Phone
(580) 379-5820
Fax
(580) 379-5829
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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 2130 OK Primary

Addresses

Primary practice location

1200 E Pecan St
Altus, OK 73521-6141

Mailing address

1200 E Pecan St
Altus, OK 73521-6141
Phone (580) 379-5820

Other identifiers 1

IdentifierTypeStateIssuer
201092560AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TeresaHurst@direct.jcmh.com

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: teresahurst@direct.jcmh.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1679092969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5820",
            "fax_number": "580-379-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "TERESA",
        "middle_name": "SHEERILEE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201092560A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TeresaHurst@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "1200 E Pecan St",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735216141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.