Active NPI
Kayla Thackery
- Speech-Language Pathologist
- Garden City, KS
National Provider Identifier
1629619036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3732
- Practice address
- 2735 N Jennie Barker Rd
Garden City, KS 67846 - Phone
- (620) 275-0291
- Fax
- (620) 275-0364
- NPI assigned
- Oct 7, 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 | 3732 | KS | Primary |
Addresses
Primary practice location
2735 N Jennie Barker Rd
Garden City, KS 67846
Mailing address
2735 N Jennie Barker Rd
Garden City, KS 67846
Phone (620) 275-0291
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | dmcnutt@rcdc4kids.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3732 | KS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570406400000",
"number": "1629619036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2735 N JENNIE BARKER RD",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "67846",
"telephone_number": "620-275-0291",
"fax_number": "620-275-0364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2735 N JENNIE BARKER RD",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "67846",
"telephone_number": "620-275-0291",
"fax_number": "620-275-0364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKERY",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-07",
"last_updated": "2019-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "3732",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "dmcnutt@rcdc4kids.org",
"affiliation": "N",
"address_1": "2735 N Jennie Barker Rd",
"city": "Garden City",
"state": "KS",
"country_code": "US",
"postal_code": "67846",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Garden City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.