Speech 4 Kids, P.C.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPEECH 4 KIDS, P.C.

Practice address

RR 3 Box 947
County Rd. 950 North
Fairfield, IL 62837-9036

Phone

(618) 847-5437

Fax

(618) 847-5438

NPI assigned

Oct 19, 2005

Organization subpart

No

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

Authorized official

Name

Kynda Pottorff, M.S. CCC/SLP

Title

President

Phone

(618) 847-5437

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447249651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 947",
            "address_2": "COUNTY RD. 950 NORTH",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628379036",
            "telephone_number": "618-847-5437",
            "fax_number": "618-847-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 947",
            "address_2": "COUNTY RD. 950 NORTH",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628379036",
            "telephone_number": "618-847-5437",
            "fax_number": "618-847-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH 4 KIDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POTTORFF",
        "authorized_official_first_name": "KYNDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-847-5437",
        "authorized_official_credential": "M.S. CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS SPEECH 4 KIDS",
            "identifier": "09632007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fairfield, IL
• Providers in Fairfield, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.