Taylor D Altom, ST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

23124 Issued in OK

Practice address

103 W Main St
Marlow, OK 73055-2437

Phone

(580) 721-7100

Fax

(833) 210-5732

NPI assigned

Apr 19, 2024

Last updated

Apr 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Rock Health and Wellness LLCGroup PAC ID 7618221375, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Rock Health and Wellness LLC

  • Physical Therapy Clinic/Center
  • Marlow, OK
  • NPI 1578046827
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1861247207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W MAIN ST",
            "city": "MARLOW",
            "state": "OK",
            "postal_code": "730552437",
            "telephone_number": "580-721-7100",
            "fax_number": "833-210-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W MAIN ST",
            "city": "MARLOW",
            "state": "OK",
            "postal_code": "730552437",
            "telephone_number": "580-721-7100",
            "fax_number": "833-210-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTOM",
        "first_name": "TAYLOR",
        "middle_name": "D",
        "credential": "ST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "23124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wyatt Austin Bergner, DPT
• Victoria Blankenship
• Blue Rock Health and Wellness LLC
• Brent Michael Boozer, D.C.
• Preston Heath Boyles, ARNP-C

• Speech-Language Pathologist in Marlow, OK
• Providers in Marlow, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.