Individual provider Active NPI

Kacie Noelle Longacre, SLP

  • Speech-Language Pathologist
  • Auburn, ME
National Provider Identifier
1447567318
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
ST2032 Issued in ME
Practice address
368 Minot Ave Ste 3
Auburn, ME 04210-4331
Phone
(207) 333-5022
NPI assigned
Sep 13, 2010
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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 ST2032 ME Primary

Addresses

Primary practice location

368 Minot Ave Ste 3
Auburn, ME 04210-4331

Mailing address

15 Memorial St
Lisbon, ME 04250-6402
Phone (207) 576-5949

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120514000195 ME Practitioner - Qualified Speech Language Pathologist 6709049653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis PT a Balanced Approach LLCGroup PAC ID 3274868898, 7 clinicians

Practice addresses (Care Compare)

368 Minot Ave
Suite 3
Auburn, ME 04210-4331
Phone (207) 333-5022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ST2032MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Davis PT: a Balanced Approach, LLC CurrentSince Dec 21, 2023 Accepting new patients

Locations

368 Minot Ave
Ste 3
Auburn, ME 04210
Phone (207) 333-5022

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1447567318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEMORIAL ST",
            "city": "LISBON",
            "state": "ME",
            "postal_code": "042506402",
            "telephone_number": "207-576-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 MINOT AVE STE 3",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042104331",
            "telephone_number": "207-333-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGACRE",
        "first_name": "KACIE",
        "middle_name": "NOELLE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST2032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.