Brighty Sara Koduvath

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101004945 Issued in MI

Practice address

5211 Marsh Rd
Okemos, MI 48864-1106

Phone

(517) 319-1400

NPI assigned

Feb 15, 2016

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

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehab Indiana LLCGroup PAC ID 9436303559, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fox Rehab Indiana LLC

  • Physical Therapist
  • Cherry Hill, NJ
  • NPI 1043568942

  IN, Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1386003606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 MARSH RD.",
            "city": "HASLETT",
            "state": "MI",
            "postal_code": "488408854",
            "telephone_number": "517-515-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 MARSH RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641106",
            "telephone_number": "517-319-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODUVATH",
        "first_name": "BRIGHTY",
        "middle_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Klingsten, M.S., OTRL
• Alexandra Klopp
• Chelsea Jo Knight, LMSW, LCSW
• Emma Knode, BEHAVIOR TECHNICIAN
• Bryce Kobe
• Adrian Koenig, LMSW
• Rebecca L Koffman, LMT
• Maddelyn Rose Koppers
• Emily I Korando, MS, BCBA
• Lance Ian Kortesoja, PA

• Speech-Language Pathologist in Okemos, MI
• Providers in Okemos, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.