Individual provider Active NPI

Sarah E Fuentes, M.A., CCC-SLP

  • Speech-Language Pathologist
  • La Grange, KY
National Provider Identifier
1710314018
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
KY-4307 Issued in KY
Practice address
4603 Timberwalk CT
La Grange, KY 40031-6746
Phone
(703) 864-6695
Fax
(888) 830-3233
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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 KY-4307 KY Primary

Addresses

Primary practice location

4603 Timberwalk CT
La Grange, KY 40031-6746

Mailing address

4014 Keighley Park LN Unit 205
Louisville, KY 40299-2785
Phone (517) 648-0133

Other practice location 1

11802 Brinley Ave
Suite 100
Louisville, KY 40243-1089
Phone (502) 244-1210

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 Arts

State licenses

LicenseStateTypeSpecialty
KY-4307KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascb Therapy LLC Speech-Language Pathologist CurrentSince Apr 19, 2020 Accepting new patients
Children'S Therapy Center, PSC Speech-Language Pathologist 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": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1710314018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 KEIGHLEY PARK LN UNIT 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992785",
            "telephone_number": "517-648-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 TIMBERWALK CT",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400316746",
            "telephone_number": "703-864-6695",
            "fax_number": "888-830-3233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11802 Brinley Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402431089",
            "country_code": "US",
            "telephone_number": "502-244-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "SARAH",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "KY-4307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.