Kathryn Deanne Dutton, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ8614 Issued in FL

Practice address

1010 N Davis St Ste 101
Jacksonville, FL 32209-6826

Phone

(904) 355-3403

NPI assigned

Oct 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1255973475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 ABESS BLVD APT 1202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256033",
            "telephone_number": "904-945-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N DAVIS ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096826",
            "telephone_number": "904-355-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "KATHRYN",
        "middle_name": "DEANNE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ8614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085375501",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdutton@shcjax.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "address_1": "1010 N Davis St Ste 101",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322096826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ravi Venkata Durvasula, MD
• Alex Dusenge Sr.
• Charles V Duss, M.D.
• Micaela Dusseault
• Annabelle Dutari Tomlinson, CMI-SPANISH
• Lauren K Dutton, MD
• Duval Aps LLC
• Duval County Health Department
• Duval County Health Department
• Duval County Health Department Pharmacy

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.