Active NPI
Kaitlyn Darlene Graham
- Speech-Language Pathologist
- Louisville, KY
National Provider Identifier
1174097729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 2701 Chestnut Station CT
Louisville, KY 40299-6395 - Phone
- (800) 465-3203
- NPI assigned
- Jan 16, 2019
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
2701 Chestnut Station CT
Louisville, KY 40299-6395
Mailing address
4508 Abbott Grove PL
Crestwood, KY 40014-8436
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 235Z00000X | Other | KY | SPEECH-LANGUAGE PATHOLOGIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1174097729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4508 ABBOTT GROVE PL",
"city": "CRESTWOOD",
"state": "KY",
"postal_code": "400148436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 CHESTNUT STATION CT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402996395",
"telephone_number": "800-465-3203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "KAITLYN",
"middle_name": "DARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH-LANGUAGE PATHOLOGIST",
"identifier": "235Z00000X",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.