NPIMap

Individual provider Active NPI

Khemwatie Saywack

  • Speech-Language Assistant
  • Winter Haven, FL
National Provider Identifier
1578936183
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI7225 Issued in FL
Practice address
820 Spring Lake SQ
Winter Haven, FL 33881-1338
Phone
(516) 343-8614
NPI assigned
Nov 4, 2015
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Speech-Language Assistant 2355S0801X SI7225 FL Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

820 Spring Lake SQ
Winter Haven, FL 33881-1338

Mailing address

820 Spring Lake SQ
Winter Haven, FL 33881-1338
Phone (516) 343-8614

Other identifiers 1

IdentifierTypeStateIssuer
111705800MedicaidFL

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
SI7225FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Love and Grow LLC Speech-Language Assistant Current Accepting new patients
City Pro Group Inc Single Specialty Past Accepting new patients
Little Tesla Pediatric Therapy LLC PastSince Oct 1, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1578936183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SPRING LAKE SQ",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811338",
            "telephone_number": "516-343-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SPRING LAKE SQ",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811338",
            "telephone_number": "516-343-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYWACK",
        "first_name": "KHEMWATIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI7225",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111705800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.