Kaitlyn Marie Grosvenor, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17240 Issued in FL

Practice address

3139 Eliza Rd
Tallahassee, FL 32308-6254

Phone

(850) 727-7928

NPI assigned

Jul 23, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Southeastern Therapy Services, LLC

  • Speech-Language Pathologist
  • Tallahassee, FL
  • NPI 1467685842
  NPD

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1104479690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3139 ELIZA RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323086254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3139 ELIZA RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323086254",
            "telephone_number": "850-727-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSVENOR",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "17240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "clinicsource",
            "affiliation": "N",
            "address_1": "3139 Eliza Rd",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323086254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly E Gromatski, L.M.T.
• Malayika Safi Groomes-Powell, APRN
• Benjamin James Grooters, DDS
• Joshua M Gross, PH.D.
• Kimberly J Gross, PA-C
• Grow Together Coaching
• Laurie Grubbs, ARNP
• Julia Francesca Gruca
• Stephanie Guanche, LCSW
• Guardian Angel Care Services,LLC

• Speech-Language Pathologist in Tallahassee, FL
• Providers in Tallahassee, 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 Jul 23, 2019; 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.