Kaitlyn L Black, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA16873 Issued in FL

Practice address

27221 Bay Landing Dr
Bonita Springs, FL 34135-4355

Phone

(239) 319-4601

NPI assigned

Jan 11, 2018

Last updated

Apr 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Ippolito Rehabilitation LLCGroup PAC ID 5092061457, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Coral Gables, FL
  • NPI 1871972653

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Ippolito Rehabilitation, LLC

  dba Complete Home Therapy

  • Physical Therapist
  • Naples, FL
  • NPI 1386140754
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1669980785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 LAKE BALDWIN LANE BOX 229",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27221 BAY LANDING DR",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354355",
            "telephone_number": "239-319-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KAITLYN",
        "middle_name": "L",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Best Home Care of SW FL Corp
• Better Sleep Florida PA
• Eliana Maria Betzios, DMD
• John Joseph Bialorucki, PT, DPT
• Bio-Medical Applications of Florida, Inc. (Bonita Springs Artificial Kidney Center)
• Katherine Blaga
• Jaclyn Blaquiere
• Ida D Blount, M.S.; LMFT
• Bmuc Holdings Inc
• Body Pain Medical Center, Inc.

• Speech-Language Pathologist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.