Individual provider Active NPI

Kristen George, MS, CCC-SLP

  • Speech-Language Pathologist
  • Kokomo, IN
National Provider Identifier
1437703394
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22006830A Issued in IN
Practice address
2108 E Boulevard
Kokomo, IN 46902-2401
Phone
(765) 416-8480
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22006830A IN Primary

Addresses

Primary practice location

2108 E Boulevard
Kokomo, IN 46902-2401

Mailing address

2108 E Boulevard
Kokomo, IN 46902-2401
Phone (765) 416-8480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509000393 IN Practitioner - Qualified Speech Language Pathologist 1456878776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince May 1, 2025 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Speech-Language Pathologist CurrentSince May 1, 2025 Accepting new patients
Pediplay LLC PastSince Aug 1, 2019 Accepting new patients

Locations

2108 E Boulevard
Kokomo, IN 46902
Phone (765) 416-8480

1805 E Hoffer St
Kokomo, IN 46902
Phone (765) 450-7261

2 Broadway Plz
Peru, IN 46970
Phone (765) 753-8829

Organizations & group practices 3

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": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1437703394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022401",
            "telephone_number": "765-416-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022401",
            "telephone_number": "765-416-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "KRISTEN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006830A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.