Individual provider Active NPI

Heather Leigh Shoesmith, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Bartlesville, OK
National Provider Identifier
1780226506
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4123 Issued in OK
Practice address
117 West 5TH Street
Bartlesville, OK 74003
Phone
(918) 203-3313
Fax
(918) 512-4082
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 4123 OK Primary

Addresses

Primary practice location

117 West 5TH Street
Bartlesville, OK 74003

Mailing address

117 West 5TH Street
Bartlesville, OK 74003
Phone (918) 203-3313

Other identifiers 1

IdentifierTypeStateIssuer
4123OtherOKSPEECH LANGUAGE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL 19185124082 Health Information Exchange (HIE)

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4123OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bartlesville Pediatric Occupational Therapy, LLC Speech-Language Pathologist PastSince Oct 20, 2019 Accepting new patients

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1780226506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST 5TH STREET",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-203-3313",
            "fax_number": "918-512-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WEST 5TH STREET",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74003",
            "telephone_number": "918-203-3313",
            "fax_number": "918-512-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOESMITH",
        "first_name": "HEATHER",
        "middle_name": "LEIGH",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE LICENSE",
            "identifier": "4123",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "19185124082",
            "affiliation": "N",
            "endpointDescription": "eFax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "117 west 5th street",
            "city": "Bartlesville",
            "state": "OK",
            "country_code": "US",
            "postal_code": "74003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.