Individual provider Active NPI

Taylor Kavkewitz

  • Speech-Language Pathologist
  • Portland, OR
National Provider Identifier
1679077176
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1610 SE Glenwood St
Portland, OR 97202-5615
Phone
(503) 927-3598
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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 Primary

Addresses

Primary practice location

1610 SE Glenwood St
Portland, OR 97202-5615

Mailing address

1610 SE Glenwood St
Portland, OR 97202-5615
Phone (503) 927-3598

Other identifiers 1

IdentifierTypeStateIssuer
14102054OtherASHA NUMBER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Atlanta Speech & Language Clinics, Inc. Speech-Language Pathologist Past Accepting new patients
Beech Street Speech and Language LLC Speech-Language Pathologist Past Accepting new patients
Greater Atlanta Speech & Language Clinics, Inc. Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 3

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1679077176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 SE GLENWOOD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025615",
            "telephone_number": "503-927-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 SE GLENWOOD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025615",
            "telephone_number": "503-927-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVKEWITZ",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA NUMBER",
            "identifier": "14102054",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.