Individual provider Active NPI

Kailey Fabrizius

  • Speech-Language Pathologist
  • Adel, IA
National Provider Identifier
1295574572
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
097831 Issued in IA
Practice address
602 Visions Pkwy
Adel, IA 50003-1672
Phone
(515) 642-3072
NPI assigned
May 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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 097831 IA Primary

Addresses

Primary practice location

602 Visions Pkwy
Adel, IA 50003-1672

Mailing address

9343 Wilson St
West Des Moines, IA 50266-5016
Phone (712) 202-6089

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
097831IAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1295574572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9343 WILSON ST",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665016",
            "telephone_number": "712-202-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VISIONS PKWY",
            "city": "ADEL",
            "state": "IA",
            "postal_code": "500031672",
            "telephone_number": "515-642-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIZIUS",
        "first_name": "KAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "097831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adel, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.