Individual provider Active NPI

Kyla Grahl, SLP

  • Speech-Language Pathologist
  • Ballwin, MO
National Provider Identifier
1346797651
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2015016738 Issued in MO
Practice address
13610 Barrett Office Dr Ste 104
Ballwin, MO 63021-7818
Phone
(314) 822-5107
Fax
(314) 822-5106
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 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 2015016738 MO Primary

Addresses

Primary practice location

13610 Barrett Office Dr Ste 104
Ballwin, MO 63021-7818

Mailing address

1190 Jefferson St Ste 103a
Washington, MO 63090-4443
Phone (636) 283-0211

Other identifiers 1

IdentifierTypeStateIssuer
2015016738OtherMOSLP LICENSE#

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Confident American English, LLC CurrentSince May 17, 2020 Accepting new patients

Locations

1190 Jefferson St
Ste 103A
Washington, MO 63090
Phone (636) 283-0211

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": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1346797651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 JEFFERSON ST STE 103A",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904443",
            "telephone_number": "636-283-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13610 BARRETT OFFICE DR STE 104",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630217818",
            "telephone_number": "314-822-5107",
            "fax_number": "314-822-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHL",
        "first_name": "KYLA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2015016738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLP LICENSE#",
            "identifier": "2015016738",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.