Individual provider Active NPI

Stacy Rathbone, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1699216465
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4671 Issued in OK
Practice address
2121 S Columbia Ave Ste 470
Tulsa, OK 74114-3518
Phone
(918) 928-4700
Fax
(918) 928-4701
NPI assigned
Mar 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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 4671 OK Primary

Addresses

Primary practice location

2121 S Columbia Ave Ste 470
Tulsa, OK 74114-3518

Mailing address

2121 S Columbia Ave Ste 470
Tulsa, OK 74114-3518
Phone (918) 928-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170420002485 OK Practitioner - Qualified Speech Language Pathologist 5496031734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swallowing and Neurological Rehabilitation, LLCGroup PAC ID 5698907046, 3 clinicians

Practice addresses (Care Compare)

2121 S Columbia Ave
Suite 470
Tulsa, OK 74114-3518
Phone (918) 928-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4671OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Swallowing and Neurological Rehabilitation, LLC CurrentSince Mar 31, 2017 Accepting new patients

Locations

2121 S Columbia Ave
Ste 501
Tulsa, OK 74114
Phone (918) 615-4015

2121 S Columbia Ave
Ste 470
Tulsa, OK 74114
Phone (918) 928-4700

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": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1699216465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 S COLUMBIA AVE STE 470",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143518",
            "telephone_number": "918-928-4700",
            "fax_number": "918-928-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S COLUMBIA AVE STE 470",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143518",
            "telephone_number": "918-928-4700",
            "fax_number": "918-928-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHBONE",
        "first_name": "STACY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.