MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) – Speech-Language Pathologist, NPI 1932653789

MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) is a healthcare provider. based in Edmond, Oklahoma. specializing in Speech-Language Pathologist. They hold the professional credentials M.ED.,CCC-SLP. They hold a License No. 2016009648 (MO). The NPI Number for MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) is 1932653789

Main info

Female
Sole Proprietor
34 Years Of Experience
Accepts Medicare Assignment
Name
MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP)
NPI
1932653789
Phone
(816) 753-5459
Address
715 GLENRIDGE DR
Enumeration Date
10 August 2016
Last Update Date
10 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8167535119
Graduation Year
1992 (34 years ago)
PAC ID
3375522675
Group Practice PAC ID
5395996284
Professional Enrollment ID
I20160916001284
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:9State licenses:3Digital endpointsOther names

Provider Addresses for MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP)

  • 715 GLENRIDGE DR

    EDMOND, OK 730131824

    Phone: (816) 753-5459

    Fax: (816) 753-5119

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73013)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395996284View full group profile
NameSpecialtyState
Unknown Individual
-CA
DR. JAMES ROBERT JR. WEBB (MD)
Diagnostic RadiologyOK
RICHARD KNEPPER (MD)
Diagnostic RadiologyOK

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Frequently asked questions

Is MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) listed with a National Provider Identifier?
Yes — MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) has NPI 1932653789 on file in the registry.
Is there an active status for MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP)?
For scheduling context, MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) is shown as active in the registry.
What clinical focus is listed for MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP)?
At a glance, MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) is tied to Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
Is MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) located near Edmond?
MRS. NICKI JO THEODORIDIS (M.ED.,CCC-SLP) currently maps to Edmond, Oklahoma in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.