Kayla Price, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146014178 Issued in IL

Practice address

3607 Heirloom Dr
Bloomington, IN 47401-5491

Phone

(812) 336-2718

NPI assigned

Jan 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652572800000",
    "number": "1477142016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4449 MCCOY RD",
            "city": "BETHALTO",
            "state": "IL",
            "postal_code": "620102513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 HEIRLOOM DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015491",
            "telephone_number": "812-336-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "KAYLA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-17",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22007059A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146014178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN STATE",
            "identifier": "22007059A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14179174",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "%!",
            "affiliation": "N",
            "address_1": "3607 Heirloom Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474015491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Premier Healthcare, LLC
• Premier Healthcare, LLC
• Premier Medical Group, LLC
• Ryan Wayne Pribble
• Kathleen P Price, NP
• Jonah Harrison Prickel
• Primary Medicine Associates, LLC
• Prime Healthcare Services - Monroe LLC
• Pritchard Jastremski Dental Assoc. LLC
• Stephen Jay Pritchard, DDS

• Speech-Language Pathologist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2022; 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.