Active NPI
Kylee Fernholz
- Speech-Language Pathologist
- Omaha, NE
National Provider Identifier
1306523949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1963
- Practice address
- 9394 W Dodge Rd Ste 300
Omaha, NE 68114-3319 - Phone
- (320) 815-0737
- NPI assigned
- Jul 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1963 | ND | Primary |
Addresses
Primary practice location
9394 W Dodge Rd Ste 300
Omaha, NE 68114-3319
Mailing address
1425 E Gateway Cir S
Fargo, ND 58103-3617
Phone (320) 815-0737
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1963 | ND | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688860800000",
"number": "1306523949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 E GATEWAY CIR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581033617",
"telephone_number": "320-815-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9394 W DODGE RD STE 300",
"city": "OMAHA",
"state": "NE",
"postal_code": "681143319",
"telephone_number": "320-815-0737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNHOLZ",
"first_name": "KYLEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-04",
"last_updated": "2023-07-09",
"certification_date": "2023-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.