Active NPI
Kaitlyn Gose
- Speech-Language Pathologist
- Tyler, TX
National Provider Identifier
1609432483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 112200
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112200 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Therapy Specialties LLC | Speech-Language Pathologist | Current | 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.