Individual provider Active NPI

Kaylee Marie Levidiotis, M.S.

  • Speech-Language Pathologist
  • Alpharetta, GA
National Provider Identifier
1306446067
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP011292 Issued in GA
Practice address
4080 McGinnis Ferry Rd # B300S302
Alpharetta, GA 30005-3948
Phone
(770) 410-7719
Fax
(770) 410-9510
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 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 SLP011292 GA Primary

Addresses

Primary practice location

4080 McGinnis Ferry Rd # B300S302
Alpharetta, GA 30005-3948

Mailing address

4080 McGinnis Ferry Rd # B300
Alpharetta, GA 30005-3948
Phone (770) 410-7719

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 Science

State licenses

LicenseStateTypeSpecialty
SLP011292GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Therapy of Forsyth, LLC Speech-Language Pathologist PastSince Jul 7, 2024 Accepting new patients

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": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1306446067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 MCGINNIS FERRY RD # B300",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053948",
            "telephone_number": "770-410-7719",
            "fax_number": "770-410-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 MCGINNIS FERRY RD # B300S302",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053948",
            "telephone_number": "770-410-7719",
            "fax_number": "770-410-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIDIOTIS",
        "first_name": "KAYLEE",
        "middle_name": "MARIE",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.