Individual provider Active NPI

Amy Wilder, M.S., SLP

  • Speech-Language Pathologist
  • Norman, OK
National Provider Identifier
1922738012
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
CF478 Issued in OK
Practice address
2429 Westport Dr
Norman, OK 73069-6337
Phone
(405) 308-9120
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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 CF478 OK Primary

Addresses

Primary practice location

2429 Westport Dr
Norman, OK 73069-6337

Mailing address

2371 County Road 1336
Blanchard, OK 73010-3595
Phone (580) 251-1220

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CF478OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1922738012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2371 COUNTY ROAD 1336",
            "city": "BLANCHARD",
            "state": "OK",
            "postal_code": "730103595",
            "telephone_number": "580-251-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2429 WESTPORT DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696337",
            "telephone_number": "405-308-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "AMY",
        "credential": "M.S., SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "CF478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 13, 2022; 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.