Active NPI
Jessica Diane Collins, M.S. CCC-SLP
- Speech-Language Pathologist
- Coweta, OK
National Provider Identifier
1689751778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3131
- Practice address
- 14540 S 302ND East Ave
Coweta, OK 74429-7845 - Phone
- (918) 486-6506
- NPI assigned
- Nov 1, 2006
- 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 | 3131 | OK | Primary |
Addresses
Primary practice location
14540 S 302ND East Ave
Coweta, OK 74429-7845
Mailing address
29833 E 155TH St S
Coweta, OK 74429-6016
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3131 | OK | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1689751778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29833 E 155TH ST S",
"city": "COWETA",
"state": "OK",
"postal_code": "744296016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14540 S 302ND EAST AVE",
"city": "COWETA",
"state": "OK",
"postal_code": "744297845",
"telephone_number": "918-486-6506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "JESSICA",
"middle_name": "DIANE",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "3131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coweta, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.