Individual provider Active NPI

Ann-Michelle Kakuda, MSED, CCC-SLP

  • Speech-Language Pathologist
  • Conway, SC
National Provider Identifier
1174768097
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7175 Issued in SC
Practice address
1266 Boswell CT
Conway, SC 29526-9543
Phone
(845) 304-8333
NPI assigned
Dec 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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 7175 SC Primary

Addresses

Primary practice location

1266 Boswell CT
Conway, SC 29526-9543

Mailing address

1266 Boswell CT
Conway, SC 29526-9543
Phone (845) 304-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715003465 SC Practitioner - Qualified Speech Language Pathologist 3476804253 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7175SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services of South Carolina, LLC Speech-Language Pathologist CurrentSince Jun 1, 2025 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1174768097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 BOSWELL CT",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269543",
            "telephone_number": "845-304-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 BOSWELL CT",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269543",
            "telephone_number": "845-304-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKUDA",
        "first_name": "ANN-MICHELLE",
        "credential": "MSED, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.