Individual provider Active NPI

Kristi Kvapil Bruton, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Georgetown, TX
National Provider Identifier
1104594688
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
19326 Issued in TX
Practice address
1601 Rockride LN
Georgetown, TX 78626-7357
Phone
(512) 943-1820
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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 19326 TX Primary

Addresses

Primary practice location

1601 Rockride LN
Georgetown, TX 78626-7357

Mailing address

4509 Miraval Loop
Round Rock, TX 78665-3929
Phone (512) 431-3627

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
19326TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1104594688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 MIRAVAL LOOP",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653929",
            "telephone_number": "512-431-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 ROCKRIDE LN",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267357",
            "telephone_number": "512-943-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUTON",
        "first_name": "KRISTI",
        "middle_name": "KVAPIL",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "19326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.