Individual provider Active NPI

Kathryn Gilligan Ryan, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Foxboro, MA
National Provider Identifier
1578170262
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3402-SP-SL Issued in MA
Practice address
71 Elm St Ste 8
Foxboro, MA 02035-2519
Phone
(347) 687-7570
NPI assigned
Sep 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 3402-SP-SL MA Primary

Addresses

Primary practice location

71 Elm St Ste 8
Foxboro, MA 02035-2519

Mailing address

28 Butch Songin Cir
South Walpole, MA 02071-1111
Phone (347) 687-7570

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3402-SP-SLMAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Our Speech Path, LLC Speech-Language Pathologist CurrentSince Sep 12, 2021 Accepting new patients

Locations

71 Elm St
Ste 8
Foxboro, MA 02035
Phone (347) 687-7570

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.

NPI Registry JSON

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

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1578170262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 BUTCH SONGIN CIR",
            "city": "SOUTH WALPOLE",
            "state": "MA",
            "postal_code": "020711111",
            "telephone_number": "347-687-7570",
            "fax_number": "508-660-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 ELM ST STE 8",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020352519",
            "telephone_number": "347-687-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KATHRYN",
        "middle_name": "GILLIGAN",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-26",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "3402-SP-SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foxboro, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.