Active NPI
Carolyn Marie Kruza, M.S., CCC/SLP
- Speech-Language Pathologist
- Winchester, VA
National Provider Identifier
1710072970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202002446
- Practice address
- 1840 Amherst St
Winchester, VA 22601-2808 - Phone
- (540) 536-1126
- Fax
- (540) 536-5139
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202002446 | VA | Primary |
| Speech-Language Pathologist | 235Z00000X | SLP-0435 | WV |
Addresses
Primary practice location
1840 Amherst St
Winchester, VA 22601-2808
Mailing address
4754 Senseny Rd
Berryville, VA 22611-3334
Phone (540) 955-2224
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01065664 | Other | ASHA CERTIFICATION | |
| 2202002446 | Other | VA | VA SLP LICENSE |
| 0154326000 | Medicaid | WV | |
| SLP-0435 | Other | WV | WV SLP LICENSE |
Other names 1
- Ms. Carolyn Marie Reus
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202002446 | VA | MD | Speech-Language Pathologist |
| SLP-0435 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1710072970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4754 SENSENY RD",
"city": "BERRYVILLE",
"state": "VA",
"postal_code": "226113334",
"telephone_number": "540-955-2224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 AMHERST ST",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226012808",
"telephone_number": "540-536-1126",
"fax_number": "540-536-5139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUZA",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "M.S., CCC/SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202002446",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "SLP-0435",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICATION",
"identifier": "01065664",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA SLP LICENSE",
"identifier": "2202002446",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0154326000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WV SLP LICENSE",
"identifier": "SLP-0435",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "REUS",
"middle_name": "MARIE",
"prefix": "MS.",
"credential": "M.S., CCC/SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.