Individual provider Active NPI

Kylie A Buatsi, CCC-SLP

  • Speech-Language Pathologist
  • Deland, FL
National Provider Identifier
1184115560
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA16257 Issued in FL
Practice address
1103 Wood Lake Ter
Deland, FL 32720-2567
Phone
(386) 917-9444
NPI assigned
May 22, 2018
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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 SA16257 FL Primary

Addresses

Primary practice location

1103 Wood Lake Ter
Deland, FL 32720-2567

Mailing address

1103 Wood Lake Ter
Deland, FL 32720-2567
Phone (386) 917-9444

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
SA16257FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1184115560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WOOD LAKE TER",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202567",
            "telephone_number": "386-917-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WOOD LAKE TER",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202567",
            "telephone_number": "386-917-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUATSI",
        "first_name": "KYLIE",
        "middle_name": "A",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.