Individual provider Active NPI

Kaley Schafer

  • Speech-Language Pathologist
  • Gilbert, AZ
National Provider Identifier
1093287724
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP11604 Issued in AZ
Practice address
690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055
Phone
(480) 820-6366
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X
Speech-Language Pathologist 235Z00000X SLP11604 AZ Primary

Addresses

Primary practice location

690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055

Mailing address

22924 E Via del Sol
Queen Creek, AZ 85142-7933
Phone (480) 395-3590

Other practice location 1

70 S Val Vista Dr
Gilbert, AZ 85296-1374
Phone (480) 818-4212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230411002280 AZ Practitioner - Qualified Speech Language Pathologist 5092180786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP11604AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mentis Reo, LLC. CurrentSince Jan 6, 2023 Accepting new patients
Advanced Therapy Solutions, LLC CurrentSince May 29, 2022 Accepting new patients
Mentis Reo, LLC. Current Accepting new patients

Locations

690 E Warner Rd
Ste 105
Gilbert, AZ 85296
Phone (480) 820-6366

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1093287724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22924 E VIA DEL SOL",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427933",
            "telephone_number": "480-395-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963055",
            "telephone_number": "480-820-6366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 S Val Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852961374",
            "country_code": "US",
            "telephone_number": "480-818-4212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "KALEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP11604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.