Individual provider Active NPI

Katlyn Ann Grams

  • Speech-Language Assistant
  • Gilbert, AZ
National Provider Identifier
1508232307
Registry record updated Aug 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
9601 Issued in AZ
Practice address
4101 E Baseline Rd
#1512
Gilbert, AZ 85234-9101
Phone
(480) 818-4212
NPI assigned
Aug 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 9601 AZ Primary

Addresses

Primary practice location

4101 E Baseline Rd
#1512
Gilbert, AZ 85234-9101

Mailing address

1415 N Country Club Dr
Apt 3066
Mesa, AZ 85201-2546
Phone (661) 414-6074

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
9601AZMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1439596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439596800000",
    "number": "1508232307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 N COUNTRY CLUB DR",
            "address_2": "APT 3066",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012546",
            "telephone_number": "661-414-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 E BASELINE RD",
            "address_2": "#1512",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852349101",
            "telephone_number": "480-818-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMS",
        "first_name": "KATLYN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-15",
        "last_updated": "2015-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "9601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2015; 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.