Organization Active NPI

Speech Swallowing and Voice Center PA

  • Speech-Language Pathologist
  • Wichita, KS
National Provider Identifier
1255571964
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2627 Issued in KS
Legal business name
SPEECH SWALLOWING AND VOICE CENTER PA
Practice address
13213 W 21St CT Ste 104
Wichita, KS 67235-9625
Phone
(316) 573-6802
Fax
(316) 721-2291
NPI assigned
Feb 20, 2009
Last updated
Mar 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Susan Lynn Kennedy, MS, CCC-SLPNPI 1720205875
Title
Owner
Phone
(316) 573-6802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2627 KS Primary
Speech-Language Pathologist 235Z00000X 1412 KS

Addresses

Primary practice location

13213 W 21St CT Ste 104
Wichita, KS 67235-9625

Mailing address

13213 W 21St CT Ste 104
Wichita, KS 67235-9625
Phone (316) 573-6802

Other practice location 1

1861 N Rock Rd Ste 101
Wichita, KS 67206-1264
Phone (316) 358-9199

Other practice location 2

345 N Riverview St Ste 104
Wichita, KS 67203-4200
Phone (316) 201-6055

Other identifiers 3

IdentifierTypeStateIssuer
30003885570005MedicaidKS
30003885570001MedicaidKS
30003885570006MedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090918000318 KS Part B Supplier - Clinic/Group Practice 7719033562 Receives reassigned benefits from 6 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Locations

13213 W 21st Ct N
#104
Wichita, KS 67235
Phone (316) 295-6845

151 N Ridge Rd
Ste 6
Wichita, KS 67212
Phone (316) 779-2560

345 N Riverview St
Ste 104
Wichita, KS 67203
Phone (316) 201-6055

345 N Riverview St
Ste 550
Wichita, KS 67203
Phone (316) 201-6055

940 N Tyler Rd
Ste 101
Wichita, KS 67212
Phone (316) 215-4719

940 N Tyler Rd
Ste 201
Wichita, KS 67212
Phone (316) 247-6288

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1255571964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13213 W 21ST CT STE 104",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672359625",
            "telephone_number": "316-573-6802",
            "fax_number": "316-721-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13213 W 21ST CT STE 104",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672359625",
            "telephone_number": "316-573-6802",
            "fax_number": "316-721-2291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1861 N Rock Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672061264",
            "country_code": "US",
            "telephone_number": "316-358-9199",
            "fax_number": "316-558-5361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 N Riverview St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672034200",
            "country_code": "US",
            "telephone_number": "316-201-6055",
            "fax_number": "316-201-1765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPEECH SWALLOWING AND VOICE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-573-6802",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2627",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "1412",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003885570005",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003885570001",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30003885570006",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.