Individual provider Active NPI

Beryl Alexandra Bobart, SLP-CCC

  • Speech-Language Pathologist
  • Lexington, KY
National Provider Identifier
1629880489
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
292464 Issued in KY
Practice address
701 Liberty Ridge LN
Lexington, KY 40509-4564
Phone
(843) 446-8587
NPI assigned
Jan 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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 292464 KY Primary

Addresses

Primary practice location

701 Liberty Ridge LN
Lexington, KY 40509-4564

Mailing address

1200 Autumn Ridge Dr
Lexington, KY 40509-2542
Phone (843) 446-8587

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204003478 KY Practitioner - Qualified Speech Language Pathologist 2264962364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Kentucky, LLCGroup PAC ID 1850729211, 108 clinicians

Practice addresses (Care Compare)

1165 Monarch St
Lexington, KY 40513-1979
Phone (844) 502-7996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
292464KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Kentucky, LLC Speech-Language Pathologist CurrentSince Jan 20, 2025 Accepting new patients
Empowerme Rehabilitation Kentucky, LLC CurrentSince Jan 20, 2025 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1629880489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 AUTUMN RIDGE DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092542",
            "telephone_number": "843-446-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 LIBERTY RIDGE LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405094564",
            "telephone_number": "843-446-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBART",
        "first_name": "BERYL",
        "middle_name": "ALEXANDRA",
        "credential": "SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "292464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.