Individual provider Active NPI

Kaiya King, CCC-SLP

  • Speech-Language Pathologist
  • Rochester, NY
National Provider Identifier
1649745944
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
031470 Issued in NY
Practice address
79 Brett Rd
Rochester, NY 14609-5719
Phone
(585) 405-1623
NPI assigned
Oct 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 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 031470 NY Primary

Addresses

Primary practice location

79 Brett Rd
Rochester, NY 14609-5719

Mailing address

79 Brett Rd
Rochester, NY 14609-5719
Phone (585) 405-1623

Other identifiers 1

IdentifierTypeStateIssuer
82046047004OtherNYMVP HEALTHCARE

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
031470NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1649745944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 BRETT RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146095719",
            "telephone_number": "585-405-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BRETT RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146095719",
            "telephone_number": "585-405-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KAIYA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "031470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHCARE",
            "identifier": "82046047004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.