Active NPI
Kathryn H Davis
- Speech-Language Pathologist
- Wallingford, CT
National Provider Identifier
1487964094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 004218
- Practice address
- 101 North Plains Industrial Road
Building 2
Wallingford, CT 06492 - Phone
- (203) 949-9337
- Fax
- (203) 284-3779
- NPI assigned
- Oct 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 004218 | CT | Primary |
Addresses
Primary practice location
101 North Plains Industrial Road
Building 2
Wallingford, CT 06492
Mailing address
1300 Post Road
Suite 204
Fairfield, CT 06824
Phone (203) 255-3669
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
| License | State | Type | Specialty |
|---|---|---|---|
| 004218 | CT | MD | Oral and Maxillofacial Radiology Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Pediatric Therapy-Wallingford, LLC | Speech-Language Pathologist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Pediatric Occupational Therapist
- Wallingford, CT
- NPI 1386707495
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1487964094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 POST ROAD",
"address_2": "SUITE 204",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "06824",
"telephone_number": "203-255-3669",
"fax_number": "203-255-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 NORTH PLAINS INDUSTRIAL ROAD",
"address_2": "BUILDING 2",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "06492",
"telephone_number": "203-949-9337",
"fax_number": "203-284-3779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KATHRYN",
"middle_name": "H",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "004218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.