NPIMap

Organization Active NPI

Tiffany Keitz Speech Pathology PLLC

  • Hearing and Speech Clinic/Center
  • Enid, OK
National Provider Identifier
1700294071
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
TIFFANY KEITZ SPEECH PATHOLOGY PLLC
Practice address
2615 E Randolph
Ste 112
Enid, OK 73701-4670
Phone
(580) 231-8081
Fax
(580) 234-2615
NPI assigned
Jul 30, 2014
Last updated
May 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tiffany Keitz, MS CCC SLPNPI 1518012681
Title
Owner/Therapist
Phone
(580) 231-8081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU Primary
Speech-Language Pathologist 235Z00000X 3182 OK

Addresses

Primary practice location

2615 E Randolph
Ste 112
Enid, OK 73701-4670

Mailing address

2615 E Randolph
Ste 112
Enid, OK 73701-4670
Phone (580) 231-8081

Other identifiers 2

IdentifierTypeStateIssuer
200125650BMedicaidOK
200545210AMedicaidOK

National Provider Directory

National Provider Directory

Locations

2615 E Randolph Ave
Ste 112
Enid, OK 73701
Phone (580) 231-8081

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1700294071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E RANDOLPH",
            "address_2": "STE 112",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014670",
            "telephone_number": "580-231-8081",
            "fax_number": "580-234-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E RANDOLPH",
            "address_2": "STE 112",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737014670",
            "telephone_number": "580-231-8081",
            "fax_number": "580-234-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY KEITZ SPEECH PATHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "KEITZ",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "580-231-8081",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3182",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200125650B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200545210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.