Individual provider Active NPI

Kayla Luedtke, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Tuscaloosa, AL
National Provider Identifier
1295352292
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4720 Issued in AL
Practice address
2703 University Blvd E
Tuscaloosa, AL 35404-3226
Phone
(205) 248-7064
NPI assigned
Jun 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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 4720 AL Primary

Addresses

Primary practice location

2703 University Blvd E
Tuscaloosa, AL 35404-3226

Mailing address

2703 University Blvd E
Tuscaloosa, AL 35404-3226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817000461 AL Practitioner - Qualified Speech Language Pathologist 1658797048 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope LLC Speech-Language Pathologist CurrentSince Jul 7, 2020 Accepting new patients

Locations

1502 Main St
Greensboro, AL 36744
Phone (205) 575-1609

2703 University Blvd E
Tuscaloosa, AL 35404
Phone (205) 248-7064

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1295352292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354043226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354043226",
            "telephone_number": "205-248-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDTKE",
        "first_name": "KAYLA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "4720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.