Active NPI
Lindsay Black
- Speech-Language Pathologist
- Stillwater, OK
National Provider Identifier
1740857721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5569
- Practice address
- 811 E Virginia Ave
Stillwater, OK 74075-7919 - Phone
- (405) 377-8255
- NPI assigned
- Jun 8, 2021
- 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 | 5569 | OK | Primary |
Addresses
Primary practice location
811 E Virginia Ave
Stillwater, OK 74075-7919
Mailing address
811 E Virginia Ave
Stillwater, OK 74075-7919
Phone (405) 377-8255
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5569 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1740857721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 E VIRGINIA AVE",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740757919",
"telephone_number": "405-377-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 E VIRGINIA AVE",
"city": "STILLWATER",
"state": "OK",
"postal_code": "740757919",
"telephone_number": "405-377-8255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "LINDSAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-08",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "5569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.