Individual provider Active NPI

Kaitlyn Rose Plohetski

  • Speech-Language Pathologist
  • Lumberton, NC
National Provider Identifier
1487437414
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101009039 Issued in MI
Practice address
765 Oakridge Blvd
Lumberton, NC 28358-2325
Phone
(910) 738-6071
NPI assigned
Aug 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30002173 NC
Speech-Language Pathologist 235Z00000X 36498 CA
Speech-Language Pathologist 235Z00000X 7101009039 MI Primary

Addresses

Primary practice location

765 Oakridge Blvd
Lumberton, NC 28358-2325

Mailing address

24487 Ridge Pole CT
South Lyon, MI 48178-8297
Phone (248) 697-7365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
36498CAMDSpeech-Language Pathologist
7101009039MIMDSpeech-Language Pathologist
30002173NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1487437414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24487 RIDGE POLE CT",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481788297",
            "telephone_number": "248-697-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 OAKRIDGE BLVD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582325",
            "telephone_number": "910-738-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOHETSKI",
        "first_name": "KAITLYN",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002173",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "36498",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101009039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.