Kelly Marie Timblin, MS, CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4754 Issued in OK

Practice address

3223 E 31St St
Tulsa, OK 74105-2452

Phone

(918) 250-7093

Fax

(918) 250-9976

NPI assigned

Sep 6, 2017

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

Other names 1

• Kelly Marie Mims Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Therapysource for Kids, Inc.

  • Hearing and Speech Clinic/Center
  • Tulsa, OK
  • NPI 1447395033

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1861910150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 E 112TH ST S",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082063",
            "telephone_number": "505-681-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052452",
            "telephone_number": "918-250-7093",
            "fax_number": "918-250-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBLIN",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "MS, CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MIMS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zoe Tillman
• Shana Kay Tilman
• Lee Ann Tilmon
• Christi Leigh Tilson
• Madeleine Tilson
• Cliff Timmons
• Erin Jae Timmons, BA
• Micah Jo Timmons
• Brian M Timms, MSW
• Timothy B. Maclin

• Speech-Language Pathologist in Tulsa, OK
• Providers in Tulsa, 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 Sep 6, 2017; 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.