Individual provider Active NPI

Kayla Head, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Wasilla, AK
National Provider Identifier
1699130898
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
113049 Issued in AK
Practice address
613 S Knik Goose Bay Rd Ste B
Wasilla, AK 99654-8090
Phone
(888) 698-9881
NPI assigned
Dec 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL60619096 WA
Speech-Language Pathologist 235Z00000X 113049 AK Primary

Addresses

Primary practice location

613 S Knik Goose Bay Rd Ste B
Wasilla, AK 99654-8090

Mailing address

7362 W Parks Hwy # 496
Wasilla, AK 99623-9300

Other practice location 1

501 N Knik St
Wasilla, AK 99654-7050
Phone (907) 215-3105

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
113049AKMDSpeech-Language Pathologist
LL60619096WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Fern Speech & Myo PLLC Speech-Language Pathologist Current Accepting new patients
Little Loon Pediatric Therapy LLC Speech-Language Pathologist Current Accepting new patients

Locations

7362 W Parks Hwy
Wasilla, AK 99623
Phone (907) 355-4083

501 N Knik St
Wasilla, AK 99654
Phone (907) 373-4325

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.

NPI Registry JSON

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1699130898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7362 W PARKS HWY # 496",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 S KNIK GOOSE BAY RD STE B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548090",
            "telephone_number": "888-698-9881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 N Knik St",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996547050",
            "country_code": "US",
            "telephone_number": "907-215-3105",
            "fax_number": "907-215-3385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEAD",
        "first_name": "KAYLA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2022-02-18",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60619096",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "113049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.