Individual provider Active NPI

Kathryn Michelle Myer, MA CCC-SLP

  • Speech-Language Pathologist
  • Indianapolis, IN
National Provider Identifier
1174775258
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22004931A Issued in IN
Practice address
1060 E 86TH St
Suite 65C
Indianapolis, IN 46240-1863
Phone
(317) 507-8074
Fax
(317) 456-5193
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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 22004931A IN Primary

Addresses

Primary practice location

1060 E 86TH St
Suite 65C
Indianapolis, IN 46240-1863

Mailing address

PO Box 40696
Indianapolis, IN 46240-0696
Phone (317) 507-8074

Other identifiers 1

IdentifierTypeStateIssuer
200000000AOtherINLPI

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 Arts

State licenses

LicenseStateTypeSpecialty
22004931AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1174775258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40696",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462400696",
            "telephone_number": "317-507-8074",
            "fax_number": "317-456-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 86TH ST",
            "address_2": "SUITE 65C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401863",
            "telephone_number": "317-507-8074",
            "fax_number": "317-456-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYER",
        "first_name": "KATHRYN",
        "middle_name": "MICHELLE",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004931A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPI",
            "identifier": "200000000A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.