Individual provider Active NPI

Kayla Ertter

  • Speech-Language Pathologist
  • North Miami, FL
National Provider Identifier
1639501463
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14549 Issued in FL
Practice address
20197 NE 16TH Place
Second Floor
North Miami, FL 33141
Phone
(201) 400-9029
NPI assigned
Aug 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Speech-Language Pathologist 235Z00000X SA14549 FL Primary

Addresses

Primary practice location

20197 NE 16TH Place
Second Floor
North Miami, FL 33141

Mailing address

300 S Biscayne Blvd Apt 426
Miami, FL 33131-5315
Phone (814) 242-2739

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

LicenseStateTypeSpecialty
SA14549FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Angels Services, Corp. Past Accepting new patients

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": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1639501463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S BISCAYNE BLVD APT 426",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331315315",
            "telephone_number": "814-242-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20197 NE 16TH PLACE",
            "address_2": "SECOND FLOOR",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "33141",
            "telephone_number": "201-400-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTTER",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-03",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.