Individual provider Active NPI

Mikayla Nadine Lewalski

  • Speech-Language Pathologist
  • San Antonio, TX
National Provider Identifier
1194472316
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
116724 Issued in TX
Practice address
20818 Gathering Oak Ste 106
San Antonio, TX 78260-3105
Phone
(210) 858-5006
NPI assigned
Mar 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 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 116724 TX Primary

Addresses

Primary practice location

20818 Gathering Oak Ste 106
San Antonio, TX 78260-3105

Mailing address

27711 Laurel Bloom
San Antonio, TX 78260-1432
Phone (210) 602-2306

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
116724TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1194472316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27711 LAUREL BLOOM",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782601432",
            "telephone_number": "210-602-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20818 GATHERING OAK STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782603105",
            "telephone_number": "210-858-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWALSKI",
        "first_name": "MIKAYLA",
        "middle_name": "NADINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "116724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.