NPIMap

Organization Active NPI

Elite Therapy, LLC

  • Speech-Language Pathologist
  • Edmond, OK
National Provider Identifier
1891218202
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2927 Issued in OK
Legal business name
ELITE THERAPY, LLC
Doing business as
Elite Therapy Associates
Practice address
1505 Renaissance Blvd
Edmond, OK 73013-3018
Phone
(405) 850-8497
Fax
(405) 300-0643
NPI assigned
Jul 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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

Authorized official

Name
Shea Nicole Parry, M.ED., M.S. CCC-SLPNPI 1366694663
Title
Owner/President
Phone
(405) 850-8497

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2927 OK Primary

Addresses

Primary practice location

1505 Renaissance Blvd
Edmond, OK 73013-3018

Mailing address

1505 Renaissance Blvd
Edmond, OK 73013-3018
Phone (405) 850-8497

Other identifiers 7

IdentifierTypeStateIssuer
200006740CMedicaidOK
2004714030AMedicaidOK
12040663OtherOKSHEA PARRY M.ED., M.S. CCC-SLP
1326194432OtherJOAN WIGGINS OTR
1043580830OtherDIANA DORETY MS CCC-SLP
1366694663OtherSHEA PARRY M.ED., M.S. CCC-SLP
100649180AMedicaidOK

Other names 1

  • Elite Therapy Associates Doing business as

National Provider Directory

National Provider Directory

Locations

1505 Renaissance Blvd
Edmond, OK 73013
Phone (405) 850-8497

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1891218202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 RENAISSANCE BLVD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133018",
            "telephone_number": "405-850-8497",
            "fax_number": "405-300-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 RENAISSANCE BLVD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133018",
            "telephone_number": "405-850-8497",
            "fax_number": "405-300-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "PARRY",
        "authorized_official_first_name": "SHEA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "405-850-8497",
        "authorized_official_credential": "M.ED., M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200006740C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004714030A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHEA PARRY M.ED., M.S. CCC-SLP",
            "identifier": "12040663",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOAN WIGGINS OTR",
            "identifier": "1326194432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIANA DORETY MS CCC-SLP",
            "identifier": "1043580830",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHEA PARRY M.ED., M.S. CCC-SLP",
            "identifier": "1366694663",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100649180A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Therapy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.