Individual provider Active NPI

Jessica Kohler

  • Speech-Language Pathologist
  • Louisville, KY
National Provider Identifier
1649664533
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
KY-3599 Issued in KY
Practice address
1205 Polo Run CT
Louisville, KY 40245-3509
Phone
(502) 552-0656
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 KY-3599 KY Primary

Addresses

Primary practice location

1205 Polo Run CT
Louisville, KY 40245-3509

Mailing address

1205 Polo Run CT
Louisville, KY 40245-3509
Phone (502) 552-0656

Other practice location 1

205 Castlerock Dr
Shepherdsville, KY 40165-6911
Phone (502) 552-0656

Other practice location 2

14207 Aiken Rd
Louisville, KY 40245-4631
Phone (502) 552-0656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170720001900 KY Practitioner - Qualified Speech Language Pathologist 6103196399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-3599KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Communication Speech-Language Pathologist CurrentSince Mar 16, 2017 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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649664533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 POLO RUN CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402453509",
            "telephone_number": "502-552-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 POLO RUN CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402453509",
            "telephone_number": "502-552-0656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Castlerock Dr",
            "address_purpose": "LOCATION",
            "city": "Shepherdsville",
            "state": "KY",
            "postal_code": "401656911",
            "country_code": "US",
            "telephone_number": "502-552-0656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14207 Aiken Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402454631",
            "country_code": "US",
            "telephone_number": "502-552-0656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "KY-3599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.