Individual provider Active NPI

Krystina Burke, M.S., CF-SLP

  • Speech-Language Pathologist
  • Waltham, MA
National Provider Identifier
1184075236
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
77189 Issued in MA
Practice address
220 Bear Hill Rd Ste 102
Waltham, MA 02451-1004
Phone
(781) 790-8479
Fax
(781) 281-9181
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202008191 VA
Speech-Language Pathologist 235Z00000X 77189 MA Primary

Addresses

Primary practice location

220 Bear Hill Rd Ste 102
Waltham, MA 02451-1004

Mailing address

220 Bear Hill Rd Ste 102
Waltham, MA 02451-1004
Phone (781) 790-8479

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
77189MAMDSpeech-Language Pathologist
2202008191VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1184075236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BEAR HILL RD STE 102",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511004",
            "telephone_number": "781-790-8479",
            "fax_number": "781-281-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BEAR HILL RD STE 102",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511004",
            "telephone_number": "781-790-8479",
            "fax_number": "781-281-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "KRYSTINA",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008191",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "77189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.