Individual provider Active NPI

Kaitlyn Jo-Ann Opar, MS, CCC-SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1538638200
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA18902 Issued in FL
Practice address
12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone
(904) 886-3228
Fax
(904) 485-8876
NPI assigned
Nov 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 121876 TX
Speech-Language Pathologist 235Z00000X SA18902 FL Primary

Addresses

Primary practice location

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618

Mailing address

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone (904) 886-3228

Other practice location 1

2765 Jefferson Davis Hwy Ste 203
Stafford, VA 22554-8331
Phone (540) 446-5323

Other names 1

  • Kaitlyn Adams Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL, MD, VA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20240502001765 TX Practitioner - Qualified Speech Language Pathologist 8325488737 Reassigns benefits to 1 organization
I20240506001027 FL Practitioner - Qualified Speech Language Pathologist 8325488737 Reassigns benefits to 1 organization
I20240708001234 MD Practitioner - Qualified Speech Language Pathologist 8325488737 Reassigns benefits to 1 organization
I20240805000225 VA Practitioner - Qualified Speech Language Pathologist 8325488737 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
121876TXMDOccupational Therapist
SA18902FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Apr 25, 2024 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Jun 7, 2024 Accepting new patients
Fleming Therapy Services, LLC Speech-Language Pathologist PastSince Jul 1, 2020 Accepting new patients

Locations

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257

1997 Annapolis Exchange Pkwy
Ste 300
Annapolis, MD 21401
Phone (410) 261-6439

3800 N Lamar Blvd
Ste 200
Austin, TX 78756
Phone (303) 578-2702

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

204 E Cano St
Edinburg, TX 78539
Phone (956) 642-0828

363 N Sam Houston Pkwy E
Ste 1100
Houston, TX 77060
Phone (281) 809-7214

10432 Balls Ford Rd
Ste 300
Manassas, VA 20109
Phone (571) 229-8708

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1543104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1538638200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618",
            "telephone_number": "904-886-3228",
            "fax_number": "904-485-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618",
            "telephone_number": "904-886-3228",
            "fax_number": "904-485-8876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2765 Jefferson Davis Hwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225548331",
            "country_code": "US",
            "telephone_number": "540-446-5323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPAR",
        "first_name": "KAITLYN",
        "middle_name": "JO-ANN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-25",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "121876",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA18902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "ADAMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.