Active NPI
Lauren Sophia Kosky
- Speech-Language Pathologist
- Dorchester, MA
National Provider Identifier
1639739287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 105 Victory Rd
Dorchester, MA 02122-3518 - Phone
- (617) 371-3010
- NPI assigned
- Jun 17, 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 | Primary |
Addresses
Primary practice location
105 Victory Rd
Dorchester, MA 02122-3518
Mailing address
105 Victory Rd
Dorchester, MA 02122-3518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4638 Victor Path
Suite 100
Hugo, MN 55038-4732
490 Hwy 96 W
Suite 300
Shoreview, MN 55126-1961
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10524 | MN | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Abilities, Inc. | Current | Accepting new patients | |
| Kids Abilities, Inc | Current | Accepting new patients |
Locations
4638 Victor Path
Ste 100
Hugo, MN 55038
Phone (651) 407-3777
490 Highway 96 W
Shoreview, MN 55126
Phone (651) 415-5490
490 Highway 96 W
Ste 300
Shoreview, MN 55126
Phone (651) 451-3016
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 and National Provider Directory roles.
-
- Clinic/Center
- Shoreview, MN
- NPI 1154455616
-
- Clinic/Center
- Hugo, MN
- NPI 1184948572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560729600000",
"number": "1639739287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 VICTORY RD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 VICTORY RD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223518",
"telephone_number": "617-371-3010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSKY",
"first_name": "LAUREN",
"middle_name": "SOPHIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-17",
"last_updated": "2019-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.