Individual provider Active NPI

Kaylie Huddleston, SLP

  • Speech-Language Pathologist
  • Lubbock, TX
National Provider Identifier
1083974935
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
106463 Issued in TX
Practice address
4601 66TH St Ste D
Lubbock, TX 79414-4875
Phone
(806) 793-3900
Fax
(806) 793-3937
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2012

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 106463 TX Primary

Addresses

Primary practice location

4601 66TH St Ste D
Lubbock, TX 79414-4875

Mailing address

4601 66TH St Ste D
Lubbock, TX 79414-4875
Phone (806) 793-3900

Other names 1

  • Kaylie Ford Other 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
106463TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337904000000",
    "number": "1083974935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 66TH ST STE D",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794144875",
            "telephone_number": "806-793-3900",
            "fax_number": "806-793-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 66TH ST STE D",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794144875",
            "telephone_number": "806-793-3900",
            "fax_number": "806-793-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "KAYLIE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "106463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLIE",
            "last_name": "FORD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.