Individual provider Active NPI

Kaitlyn Ann Nawa

  • Speech-Language Pathologist
  • Clinton, IA
National Provider Identifier
1245878776
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
002205 Issued in IA
Practice address
849 13TH Ave N
Clinton, IA 52732-5168
Phone
(563) 244-2603
NPI assigned
Dec 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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 002205 IA Primary

Addresses

Primary practice location

849 13TH Ave N
Clinton, IA 52732-5168

Mailing address

1711 Mackin Dr
De Witt, IA 52742-1084
Phone (563) 357-8010

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address alvernotherapy@selectrehab.com Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
002205IAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1245878776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 MACKIN DR",
            "city": "DE WITT",
            "state": "IA",
            "postal_code": "527421084",
            "telephone_number": "563-357-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325168",
            "telephone_number": "563-244-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAWA",
        "first_name": "KAITLYN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "002205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alvernotherapy@selectrehab.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Therapy email",
            "address_1": "849 13th Ave N",
            "city": "Clinton",
            "state": "IA",
            "country_code": "US",
            "postal_code": "527325168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

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