Individual provider Active NPI

Kathryn Goltl, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Olmsted TWP, OH
National Provider Identifier
1306203559
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.11496 Issued in OH
Practice address
26376 John Rd
Olmsted TWP, OH 44138-1277
Phone
(440) 235-7100
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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 SP.11496 OH Primary

Addresses

Primary practice location

26376 John Rd
Olmsted TWP, OH 44138-1277

Mailing address

16600 W Sprague Rd
Cleveland, OH 44130-6318
Phone (216) 227-7700

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP.11496OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1306203559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16600 W SPRAGUE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441306318",
            "telephone_number": "216-227-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26376 JOHN RD",
            "city": "OLMSTED TWP",
            "state": "OH",
            "postal_code": "441381277",
            "telephone_number": "440-235-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLTL",
        "first_name": "KATHRYN",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olmsted TWP, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.