Individual provider Active NPI

Kayle Rutar, M.S.,CF-SLP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1013506047
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP12819 Issued in AZ
Practice address
10251 N 35TH Ave
Phoenix, AZ 85051-1305
Phone
(602) 995-7366
NPI assigned
Jan 14, 2021
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 TSLP12819 AZ Primary

Addresses

Primary practice location

10251 N 35TH Ave
Phoenix, AZ 85051-1305

Mailing address

17411 N 28TH Ave
Phoenix, AZ 85053-1958
Phone (320) 828-3847

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
TSLP12819AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1013506047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17411 N 28TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850531958",
            "telephone_number": "320-828-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10251 N 35TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511305",
            "telephone_number": "602-995-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTAR",
        "first_name": "KAYLE",
        "credential": "M.S.,CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP12819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.