Kathryn Jackson Altenbach

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

13453 N Main St Ste 401
Jacksonville, FL 32218-2774

Phone

(904) 249-8893

NPI assigned

Feb 14, 2018

Last updated

Jul 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1366942500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 9TH AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322507142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182774",
            "telephone_number": "904-249-8893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 3rd St S Ste 2",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322508038",
            "country_code": "US",
            "telephone_number": "904-249-8893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 9th Ave N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "32250",
            "country_code": "US",
            "telephone_number": "904-249-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTENBACH",
        "first_name": "KATHRYN",
        "middle_name": "JACKSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael R Alston, MD
• Kristina A Altadonna, CRNA
• Abdallah Mahmoud Altantawi, MD
• Altec Diagnostics & Imaging Inc (Altec High-Field Open Diagnostic Imaging Center)
• Renee E Alten
• Sean M Altenbach, D.M.D.
• Altercare LLC (Trilogy Home Healthcare)
• Alissa Alterman, O.D.
• Katherine L. Altis
• Altitude Health Corp I LLC

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.