Individual provider Active NPI

Kathryn Hutyra

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1700340726
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
17222 Issued in FL
Practice address
13241 Bartram Park Blvd Unit 1913
Jacksonville, FL 32258-5228
Phone
(904) 249-8893
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 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 17222 FL Primary

Addresses

Primary practice location

13241 Bartram Park Blvd Unit 1913
Jacksonville, FL 32258-5228

Mailing address

458 Vineyard LN
Orange Park, FL 32073-7678
Phone (850) 380-8984

Other practice location 1

458 Vineyard Ln
Orange Park, FL 32073-7678
Phone (850) 380-8984

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
17222FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Talk Place LLC PastSince Oct 17, 2021 Accepting new patients
Kids Talk Place LLC Past Accepting new patients

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": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1700340726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 VINEYARD LN",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320737678",
            "telephone_number": "850-380-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 1913",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585228",
            "telephone_number": "904-249-8893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "458 Vineyard Ln",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320737678",
            "country_code": "US",
            "telephone_number": "850-380-8984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTYRA",
        "first_name": "KATHRYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "17222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

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