Carolyn M Kavanagh

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

C-4984 Issued in NM

Practice address

1241A Cerro Gordo Rd
Santa Fe, NM 87501-6106

Phone

(307) 760-7079

Fax

(505) 467-2648

NPI assigned

Aug 24, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1083994891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241A CERRO GORDO RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875016106",
            "telephone_number": "307-760-7079",
            "fax_number": "505-467-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241A CERRO GORDO RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875016106",
            "telephone_number": "307-760-7079",
            "fax_number": "505-467-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "C-4984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E7606",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Howard Katz, DDS
• Sue Katz, MD
• Lisa Kaufman, RN
• Paul W Kaufman, M.D.
• Robert Page Kaufman, LCSW/MA
• Liam James Kavin, DPT
• Courtney Kayser
• Kaytea Hendricks Psychotherapy, LLC
• Keadron T Finn, LLC
• Pamela Kear, LCSW

• Speech-Language Pathologist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.