Individual provider Active NPI

Kalie Menders

  • Speech-Language Pathologist
  • Waterford, CT
National Provider Identifier
1588276950
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6293 Issued in CT
Practice address
79 Cross Rd
Waterford, CT 06385-1621
Phone
(860) 460-7103
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 6293 CT Primary

Addresses

Primary practice location

79 Cross Rd
Waterford, CT 06385-1621

Mailing address

79 Cross Rd
Waterford, CT 06385-1621

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

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1588276950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 CROSS RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 CROSS RD",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851621",
            "telephone_number": "860-460-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDERS",
        "first_name": "KALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "6293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.