Individual provider Active NPI

Kaitlyn Gose

  • Speech-Language Pathologist
  • Tyler, TX
National Provider Identifier
1609432483
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
112200 Issued in TX
Practice address
9846 Hwy 31 E
Tyler, TX 75705-2329
Phone
(903) 592-8001
Fax
(903) 525-3858
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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 112200 TX Primary

Addresses

Primary practice location

9846 Hwy 31 E
Tyler, TX 75705-2329

Mailing address

9846 Hwy 31 E
Tyler, TX 75705-2329
Phone (903) 592-8001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201028001998 TX Practitioner - Qualified Speech Language Pathologist 7810307196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112200TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Therapy Specialties LLC Speech-Language Pathologist CurrentSince Jul 15, 2020 Accepting new patients

Locations

4900 Sanger Ave
Waco, TX 76710
Phone (254) 644-2423

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": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1609432483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9846 HWY 31 E",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757052329",
            "telephone_number": "903-592-8001",
            "fax_number": "903-525-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9846 HWY 31 E",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757052329",
            "telephone_number": "903-592-8001",
            "fax_number": "903-525-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSE",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "112200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.