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Tracy Michele Jimenez , SLP-CCC

Speech-Language Pathologist β€’ Ada, OK

Active NPI 1548452709 Individual Practitioner Female Practitioner
Practice location in NPPES

430 N Monte Vista St
Ada, OK 748204610

Call 5804211303 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

430 N Monte Vista St

Ada, OK 748204610

Telephone 5804211303
Organization at the Same NPPES Address or Phone
Valley View Hospital Facility NPI 1619938040

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Ada and Oklahoma

7 active clinicians are listed under Speech-Language Pathologist with a practice address in Ada, OK (2,454 in Oklahoma).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-08-24
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES OK 3610

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES AZ SLP1515

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oklahoma State Board of Medical Licensure.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

26 listed
Dr. Junaid Alam , DO

Internal Medicine

NPI 1881222024

Doctor of Osteopathic Medicine (D.O.)

Dr. Ashtami Banavali , MD

Internal Medicine - Hematology & Oncology

NPI 1902184518

Doctor of Medicine (M.D.)

Kevin Beaver

Physician Assistant

NPI 1528426442
Bradley Brown , PA

Emergency Medicine

NPI 1871085829

Physician Assistant

NPI 1730214578

Doctor of Medicine (M.D.)

Agbortambeng Enoweyere

Nurse Anesthetist, Certified Registered

NPI 1831963834

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location August 24, 2022

Registered at 430 N MONTE VISTA ST, ADA, OK 748204610 (Tel: 5804211303)

πŸ“
Updated Business Mailing Address August 24, 2022

Registered at 515 W KINGS RD, ADA, OK 748208125 (Tel: 6024992016)

πŸ‘€
Provider Name / Credentials Updated August 24, 2022

Recorded as TRACY JIMENEZ, SLP-CCC

βœ…
NPI Profile Active August 13, 2007

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 13, 2007

Registered at 7938 E SAN MIGUEL AVE, SCOTTSDALE, AZ 852506518 (Tel: 4809900359)

πŸ“
Business Mailing Address (Initial Record) August 13, 2007

Registered at 7938 E SAN MIGUEL AVE, SCOTTSDALE, AZ 852506518 (Tel: 4809900359)

πŸ‘€
Provider Name / Credentials (Initial Record) August 13, 2007

Recorded as TRACY WALLER, SLP-CCC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 13, 2007

Speech-Language Pathologist (license number reported to NPPES: AZ SLP1515)

🟒
Initial NPI Registration & Enumeration August 13, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1548452709
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 13, 2007
Last Update: August 24, 2022
Sole Proprietor: Yes

Mailing Address

515 W Kings Rd

Ada, OK 748208125

Phone: 6024992016

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.