Kylee Peterson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

034714 Issued in NY

Practice address

4500 Crown Rd
Liverpool, NY 13090-3507

Phone

(315) 453-4604

NPI assigned

Sep 9, 2024

Last updated

Dec 13, 2024By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifespan Speech and Swallowing Services

  dba Speech Therapy for All CNY

  • Speech-Language Pathologist
  • Liverpool, NY
  • NPI 1932798592
  NPD (past)

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1427884485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4754",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132214754",
            "telephone_number": "315-433-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 CROWN RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130903507",
            "telephone_number": "315-453-4604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4820 W Taft Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130882806",
            "country_code": "US",
            "telephone_number": "315-552-0406",
            "fax_number": "315-634-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "034714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Now Medical Care, PLLC
• Benjamin Peet, DPT
• Emilia Kathleen Peluso, PA-C
• Wilfredo Perez, CASAC-T
• Charles Perla, MD
• Stephanie Petrone, M. ED.
• Kathrin Petterelli
• Eric O Pettit, DDS
• Kim-Anh Ngoc Pham, FNP-C
• Andrew Ian Philip, M.D.

• Speech-Language Pathologist in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.