Keith Jude Kolesar, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6948 Issued in FL

Practice address

1526 White Hall Dr
Apt. 102
Davie, FL 33324-6678

Phone

(561) 789-1799

Fax

(954) 382-5781

NPI assigned

Aug 20, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Speech Rehab Services LLC

  • Home Health Agency
  • Boca Raton, FL
  • NPI 1114268927
  NPD (past)
• Speech Therapy on the Go, Inc.

  • Speech-Language Pathologist
  • Davie, FL
  • NPI 1811137540
  NPD (past)

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250726400000",
    "number": "1093947210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WHITE HALL DR",
            "address_2": "APT. 102",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333246678",
            "telephone_number": "561-789-1799",
            "fax_number": "954-382-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 WHITE HALL DR",
            "address_2": "APT. 102",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333246678",
            "telephone_number": "561-789-1799",
            "fax_number": "954-382-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESAR",
        "first_name": "KEITH",
        "middle_name": "JUDE",
        "name_prefix": "Mr.",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathalie Koenig, D.O.
• Aubrey Kohler
• Julia Lynn Kohler
• Divya Kohli, BDS, MDS
• Morey J Kolber, P.T.
• Pradeep Komarneni
• Alexa Kopp, M.S., CCC-SLP
• David J Korn, MD
• Alexa Rose Kornitzer
• Cathelene Hanna Koshy

• Speech-Language Pathologist in Davie, FL
• Providers in Davie, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.