Individual provider Active NPI

Kaysi Valverde, SLP

  • Speech-Language Pathologist
  • Grovetown, GA
National Provider Identifier
1427616309
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET002889 Issued in GA
Practice address
5176 Wrightsboro Rd
Grovetown, GA 30813-2802
Phone
(706) 842-3330
Fax
(706) 426-1168
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP010988 GA
Speech-Language Pathologist 235Z00000X PCET002889 GA Primary

Addresses

Primary practice location

5176 Wrightsboro Rd
Grovetown, GA 30813-2802

Mailing address

5176 Wrightsboro Rd
Grovetown, GA 30813-2802
Phone (706) 842-3330

Other practice location 1

1120 15th St
Augusta, GA 30912-2802
Phone (706) 721-8623

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@therapytrailsga.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715000662 GA Practitioner - Qualified Speech Language Pathologist 5092117994 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PCET002889GAMDSpeech-Language Pathologist
SLP010988GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Au Medical Center, Inc CurrentSince Jul 1, 2021 Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1427616309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5176 WRIGHTSBORO RD",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132802",
            "telephone_number": "706-842-3330",
            "fax_number": "706-426-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 WRIGHTSBORO RD",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132802",
            "telephone_number": "706-842-3330",
            "fax_number": "706-426-1168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309122802",
            "country_code": "US",
            "telephone_number": "706-721-8623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALVERDE",
        "first_name": "KAYSI",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010988",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET002889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@therapytrailsga.com",
            "affiliation": "N",
            "endpointDescription": "Practice Office Email",
            "address_1": "5176 Wrightsboro Rd",
            "city": "Grovetown",
            "state": "GA",
            "country_code": "US",
            "postal_code": "308132802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grovetown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.