Individual provider Active NPI

Kaitlyn R Brazauskas, MS, CCC-SLP

  • Speech-Language Pathologist
  • Zelienople, PA
National Provider Identifier
1124449343
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL011359 Issued in PA
Practice address
105 Burgess Dr
Zelienople, PA 16063-2525
Phone
(724) 452-3596
NPI assigned
Dec 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2017

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 SL011359 PA Primary

Addresses

Primary practice location

105 Burgess Dr
Zelienople, PA 16063-2525

Mailing address

105 Burgess Dr
Zelienople, PA 16063-2525
Phone (724) 452-3596

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 Science

State licenses

LicenseStateTypeSpecialty
SL011359PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1124449343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BURGESS DR",
            "city": "ZELIENOPLE",
            "state": "PA",
            "postal_code": "160632525",
            "telephone_number": "724-452-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BURGESS DR",
            "city": "ZELIENOPLE",
            "state": "PA",
            "postal_code": "160632525",
            "telephone_number": "724-452-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZAUSKAS",
        "first_name": "KAITLYN",
        "middle_name": "R",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-16",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL011359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zelienople, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.