Individual provider Active NPI

Sara Pinkepank, MS, CCC-SLP

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1770952186
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4402 Issued in OK
Practice address
5214 S 67TH East PL
Tulsa, OK 74145-7614
Phone
(918) 694-7276
Fax
(539) 664-9820
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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 4402 OK Primary

Addresses

Primary practice location

5214 S 67TH East PL
Tulsa, OK 74145-7614

Mailing address

5214 S 67TH East PL
Tulsa, OK 74145-7614
Phone (918) 694-7276

Other practice location 1

1405 4th Ave NW # 296
Ardmore, OK 73401-2708
Phone (580) 795-4561

Other names 1

  • Sara Bennett Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200226001039 OK Practitioner - Qualified Speech Language Pathologist 6709213150 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Speech and Language Services, LLC Speech-Language Pathologist CurrentSince Jan 1, 2020 Accepting new patients
Summit Rehab LLC Speech-Language Pathologist PastSince Jan 1, 2010 Accepting new patients

Organizations & group practices 2

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1770952186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5214 S 67TH EAST PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741457614",
            "telephone_number": "918-694-7276",
            "fax_number": "539-664-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5214 S 67TH EAST PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741457614",
            "telephone_number": "918-694-7276",
            "fax_number": "539-664-9820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 4th Ave NW # 296",
            "address_purpose": "LOCATION",
            "city": "Ardmore",
            "state": "OK",
            "postal_code": "734012708",
            "country_code": "US",
            "telephone_number": "580-795-4561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINKEPANK",
        "first_name": "SARA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "BENNETT",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.