Active NPI
Kathy L Vandergriff, SLP
- Speech-Language Pathologist
- Newburgh, IN
National Provider Identifier
1104901321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22002434A
- Practice address
- 4011 Gateway Blvd
Newburgh, IN 47630-8947 - Phone
- (812) 842-3770
- Fax
- (812) 842-3771
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22002434A | IN | Primary |
Addresses
Primary practice location
4011 Gateway Blvd
Newburgh, IN 47630-8947
Mailing address
1808 Sherman Drive
Princeton, IN 47670-1043
Phone (812) 385-9201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22002434A | Other | IN | LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22002434A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1104901321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 SHERMAN DRIVE",
"city": "PRINCETON",
"state": "IN",
"postal_code": "476701043",
"telephone_number": "812-385-9201",
"fax_number": "812-385-9307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4011 GATEWAY BLVD",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476308947",
"telephone_number": "812-842-3770",
"fax_number": "812-842-3771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERGRIFF",
"first_name": "KATHY",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22002434A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "22002434A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.