Kacie Wittke, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

004492 Issued in CT

Practice address

850 Bolton Rd
Storrs Mansfield, CT 06269-9020

Phone

(860) 486-2817

NPI assigned

Oct 10, 2018

Last updated

Nov 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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 CT

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Connecticut Health Center

  dba University Physicians

  • General Practice Physician
  • Farmington, CT
  • NPI 1720083769
  Medicare reassignment NPD
• University of Connecticut

  dba University of Connecticut Speech & Hearing Clinic

  • Audiologist
  • Storrs, CT
  • NPI 1114011830
  Medicare reassignment
• University of Connecticut Health Center

  dba University Physicians

  • Durable Medical Equipment & Medical Supplies
  • Farmington, CT
  • NPI 1104809375
  NPD
• University of Connecticut Health Center

  • Clinical Medical Laboratory
  • Farmington, CT
  • NPI 1427031293
  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1407321052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BOLTON RD",
            "city": "STORRS MANSFIELD",
            "state": "CT",
            "postal_code": "062699020",
            "telephone_number": "860-486-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BOLTON RD",
            "city": "STORRS MANSFIELD",
            "state": "CT",
            "postal_code": "062699020",
            "telephone_number": "860-486-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTKE",
        "first_name": "KACIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "004492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Connecticut
• University of Connecticut (Nayden Rehabilitation Clinic)
• University of Connecticut Student Health and Wellness
• Margaret Van Kuren, LCSW
• Douglas M Whittemore, MD.
• Terry O'Neill Yanaway, AU.D.
• Gregory Erik Zars

• Speech-Language Pathologist in Storrs Mansfield, CT
• Providers in Storrs Mansfield, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.

Verify at the official NPI Registry.