Individual provider Active NPI

Kimberly Claborn, SLP

  • Speech-Language Pathologist
  • Claremore, OK
National Provider Identifier
1821007873
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2016 Issued in OK
Practice address
1071 W Blue Starr Dr
Claremore, OK 74017-2638
Phone
(918) 341-4343
Fax
(918) 341-8687
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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 2016 OK Primary

Addresses

Primary practice location

1071 W Blue Starr Dr
Claremore, OK 74017-2638

Mailing address

1071 W Blue Starr Dr
Claremore, OK 74017-2638
Phone (918) 341-4343

Other identifiers 1

IdentifierTypeStateIssuer
100637590CMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090709000503 OK Practitioner - Qualified Speech Language Pathologist 9931251717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Oklahoma LLC CurrentSince Sep 26, 2016 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2560 E Kenosha St
Broken Arrow, OK 74014
Phone (918) 994-7864

1071 W Blue Starr Dr
Ste 105
Claremore, OK 74017
Phone (918) 283-2992

1355 W Rogers Blvd
Ste 10
Skiatook, OK 74070
Phone (918) 396-7125

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1821007873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 W BLUE STARR DR",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740172638",
            "telephone_number": "918-341-4343",
            "fax_number": "918-341-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 W BLUE STARR DR",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740172638",
            "telephone_number": "918-341-4343",
            "fax_number": "918-341-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLABORN",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100637590C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.