Outside the Box Speech Services, LLC

Key facts

NPI

1801259692

Entity type

Organization (NPI type 2)

Primary specialty

Hearing and Speech Clinic/Center 261QH0700X

License

3498 (OK)

Legal business name

OUTSIDE THE BOX SPEECH SERVICES, LLC

Practice address

19001 S 369TH West Ave
Bristow, OK 74010-2067

Phone

(405) 255-0642

NPI assigned

Mar 30, 2016

Organization subpart

No

Authorized official

Name

Jennifer N Kemp, MS, CCC-SLP

Title

Speech-Language Pathologist

Phone

(405) 255-0642

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 30, 2016.

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1801259692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19001 S 369TH WEST AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102067",
            "telephone_number": "405-255-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19001 S 369TH WEST AVE",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740102067",
            "telephone_number": "405-255-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTSIDE THE BOX SPEECH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "405-255-0642",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "OK",
            "license": "3498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200241250A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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