Kaitlyn McKenzie Evans, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S4852 Issued in MS

Practice address

13 Northtown Dr Ste 110
Jackson, MS 39211-3047

Phone

(601) 206-9195

Fax

(601) 957-8391

NPI assigned

Oct 16, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Trinity Rehabilitation Inc

  • Physical Therapist
  • Jackson, MS
  • NPI 1588759369

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1104608124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 NORTHTOWN DR STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113047",
            "telephone_number": "601-206-9195",
            "fax_number": "601-957-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 NORTHTOWN DR STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113047",
            "telephone_number": "601-206-9195",
            "fax_number": "601-957-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KAITLYN",
        "middle_name": "MCKENZIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S4852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Evans
• Jennifer Brook Evans, RN
• John Peter Evans, MA
• Joshua Evans, LPC, LMFT
• Joshua Evans
• Kiajah Evans
• Kimberly Pershun Evans, PHARMD
• Kimbrell Evans, M.S.
• Makeba Evans
• Mary Michael Evans

• Speech-Language Pathologist in Jackson, MS
• Providers in Jackson, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.