Individual provider Active NPI

Nicole Ann Kaizen, SPEECH PATHOLOGIST

  • Speech-Language Pathologist
  • Nazareth, PA
National Provider Identifier
1255456083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL004211L Issued in PA
Practice address
Gracedale Avenue
Nazareth, PA 18064-9213
Phone
(610) 746-1947
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SL004211L PA Primary

Addresses

Primary practice location

Gracedale Avenue
Nazareth, PA 18064-9213

Mailing address

2590 Gillian LN
Easton, PA 18040-5820
Phone (610) 250-5801

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
SL004211LPAMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: nicole.kaizen@upmcdirect.com

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255456083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 GILLIAN LN",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180405820",
            "telephone_number": "610-250-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRACEDALE AVENUE",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180649213",
            "telephone_number": "610-746-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIZEN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL004211L",
            "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 Jul 8, 2007; 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.