Kayla Marie Peterson, MS-CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3819 Issued in KS

Practice address

7227 Goodman St
Overland Park, KS 66204-1741

Phone

(913) 961-6380

NPI assigned

May 27, 2015

Last updated

Sep 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Connect the Dots Pediatric Therapy LLC

  • Speech-Language Pathologist
  • Overland Park, KS
  • NPI 1306435946
  NPD Authorized official

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1619356375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 GOODMAN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662041741",
            "telephone_number": "913-961-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 GOODMAN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662041741",
            "telephone_number": "913-961-6380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8031 W Center Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681243134",
            "country_code": "US",
            "telephone_number": "402-763-4408",
            "fax_number": "402-343-1278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1761",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "3819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47065477700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane Petersen
• Teresa Petersen, PT, MS, PCS
• Cynthia Sandquist Peterson, P.T.
• Elizabeth Sorrells Peterson, MD
• Grace Katherine Peterson, LMLP-T
• Lori D Peterson
• Maggie Peterson, LMSW
• Michael Joseph Peterson, PT DPT
• Paul Peterson, CRNA
• Rachael Peterson

• Speech-Language Pathologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Speech-Language Pathologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.