Individual provider Active NPI

Krista Ytkin, CCC-SLP

  • Speech-Language Pathologist
  • Nazareth, PA
National Provider Identifier
1174822746
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
080119906 Issued in PA
Practice address
4578 Oakwood LN
Nazareth, PA 18064-8670
Phone
(570) 851-0738
Fax
(610) 365-2171
NPI assigned
Mar 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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 080119906 PA Primary

Addresses

Primary practice location

4578 Oakwood LN
Nazareth, PA 18064-8670

Mailing address

297 Newport Ave
Nazareth, PA 18064-9194
Phone (610) 390-2423

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

LicenseStateTypeSpecialty
080119906PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1174822746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 NEWPORT AVE",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180649194",
            "telephone_number": "610-390-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4578 OAKWOOD LN",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180648670",
            "telephone_number": "570-851-0738",
            "fax_number": "610-365-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YTKIN",
        "first_name": "KRISTA",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "080119906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nazareth, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.