Active NPI
Maggie Renee Kuykendall, MS
- Speech-Language Pathologist
- Hettick, IL
National Provider Identifier
1376722298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.009611
- Practice address
- 25596 Melrose LN
Hettick, IL 62649-4155 - Phone
- (618) 778-2006
- NPI assigned
- Oct 27, 2007
- 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 | 146.009611 | IL | Primary |
Addresses
Primary practice location
25596 Melrose LN
Hettick, IL 62649-4155
Mailing address
25596 Melrose LN
Hettick, IL 62649-4155
Phone (618) 778-2006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.009611 | IL | MD | Speech-Language Pathologist |
Organizations & group practices 2
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.
-
- Occupational Therapist
- Edwardsville, IL
- NPI 1679098263
-
- Multi-Specialty Clinic/Center
- Belleville, IL
- NPI 1174118103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224115200000",
"number": "1376722298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25596 MELROSE LN",
"city": "HETTICK",
"state": "IL",
"postal_code": "626494155",
"telephone_number": "618-778-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25596 MELROSE LN",
"city": "HETTICK",
"state": "IL",
"postal_code": "626494155",
"telephone_number": "618-778-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUYKENDALL",
"first_name": "MAGGIE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-27",
"last_updated": "2008-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.009611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.