Active NPI
Stephanie Willbanks
- Speech-Language Pathologist
- Kingfisher, OK
National Provider Identifier
1699141945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3326
- Practice address
- 602 W Chisholm Dr
Kingfisher, OK 73750-4348 - Phone
- (405) 375-4194
- NPI assigned
- Aug 20, 2015
- Last updated
- Aug 20, 2015
- 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 | 3326 | OK | Primary |
Addresses
Primary practice location
602 W Chisholm Dr
Kingfisher, OK 73750-4348
Mailing address
1201 Walton TRL
Kingfisher, OK 73750-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12097386 | Other | AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3326 | OK | MD | Pediatric Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1699141945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 WALTON TRL",
"city": "KINGFISHER",
"state": "OK",
"postal_code": "737504500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 W CHISHOLM DR",
"city": "KINGFISHER",
"state": "OK",
"postal_code": "737504348",
"telephone_number": "405-375-4194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLBANKS",
"first_name": "STEPHANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-20",
"last_updated": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "3326",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION",
"identifier": "12097386",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingfisher, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.