Individual provider Active NPI

Kelli Benton

  • Speech-Language Pathologist
  • Norman, OK
National Provider Identifier
1922526805
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4749 Issued in OK
Practice address
2002 E Robinson St
Norman, OK 73071-7420
Phone
(405) 307-2800
NPI assigned
Aug 31, 2017
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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 4749 OK Primary

Addresses

Primary practice location

2002 E Robinson St
Norman, OK 73071-7420

Mailing address

2002 E Robinson St
Norman, OK 73071-7420
Phone (405) 307-2800

Other names 1

  • Kelli Swain Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4749OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bilingual Pediatric Therapies Speech-Language Pathologist PastSince Aug 1, 2023 Accepting new patients
Walnut Behavioral Therapy LLC PastSince Oct 6, 2024 Accepting new patients
Walker Square Therapy LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1922526805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 E ROBINSON ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730717420",
            "telephone_number": "405-307-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 E ROBINSON ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730717420",
            "telephone_number": "405-307-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "SWAIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.