Active NPI
Kathleen Krull
- Speech-Language Pathologist
- Chesterfield, MI
National Provider Identifier
1497430490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101001108
- Practice address
- 53189 Elysia Dr
Chesterfield, MI 48051-1767 - Phone
- (586) 315-8845
- NPI assigned
- Jun 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 7101001108 | MI | Primary |
Addresses
Primary practice location
53189 Elysia Dr
Chesterfield, MI 48051-1767
Mailing address
51194 Romeo Plank Rd
PMB 444
Macomb, MI 48042
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 |
|---|---|---|---|
| 7101001108 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1497430490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51194 ROMEO PLANK RD",
"address_2": "PMB 444",
"city": "MACOMB",
"state": "MI",
"postal_code": "48042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53189 ELYSIA DR",
"city": "CHESTERFIELD",
"state": "MI",
"postal_code": "480511767",
"telephone_number": "586-315-8845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRULL",
"first_name": "KATHLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-16",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101001108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.