Individual provider Active NPI

Karen McCabe Larusso, M.A.CCC-SLP

  • Speech-Language Pathologist
  • Gilbert, SC
National Provider Identifier
1487837639
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3443 Issued in SC
Practice address
509 Shore Rd
Gilbert, SC 29054-9164
Phone
(803) 892-6193
NPI assigned
Dec 11, 2007
Last updated
Dec 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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 3443 SC Primary

Addresses

Primary practice location

509 Shore Rd
Gilbert, SC 29054-9164

Mailing address

509 Shore Rd
Gilbert, SC 29054-9164
Phone (803) 892-6193

Other identifiers 1

IdentifierTypeStateIssuer
SA0466MedicaidSC

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
3443SCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1487837639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 SHORE RD",
            "city": "GILBERT",
            "state": "SC",
            "postal_code": "290549164",
            "telephone_number": "803-892-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SHORE RD",
            "city": "GILBERT",
            "state": "SC",
            "postal_code": "290549164",
            "telephone_number": "803-892-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUSSO",
        "first_name": "KAREN",
        "middle_name": "MCCABE",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0466",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.