Active NPI
Kathryn Greer Fagan
- Speech-Language Pathologist
- Valparaiso, FL
National Provider Identifier
1376342741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA23327
- Practice address
- 170 Grandview Ave
Valparaiso, FL 32580-1542 - Phone
- (334) 224-2630
- NPI assigned
- Mar 10, 2025
- Sex
- Female
- Sole proprietor
- No
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 | SA23327 | FL | Primary |
Addresses
Primary practice location
170 Grandview Ave
Valparaiso, FL 32580-1542
Mailing address
170 Grandview Ave
Valparaiso, FL 32580-1542
Phone (334) 224-2630
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 |
|---|---|---|---|
| SA23327 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Absolute Therapy, LLC | Speech-Language Pathologist | Past | 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": "1741564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1376342741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 GRANDVIEW AVE",
"city": "VALPARAISO",
"state": "FL",
"postal_code": "325801542",
"telephone_number": "334-224-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 GRANDVIEW AVE",
"city": "VALPARAISO",
"state": "FL",
"postal_code": "325801542",
"telephone_number": "334-224-2630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGAN",
"first_name": "KATHRYN",
"middle_name": "GREER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-10",
"last_updated": "2025-03-10",
"certification_date": "2025-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA23327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valparaiso, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.