Active NPI
Kalyan Nagalla, SPEECH THERAPIST
- Speech-Language Pathologist
- Spanaway, WA
National Provider Identifier
1740534825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 516 176TH St E
Spanaway, WA 98387-8335 - Phone
- (253) 683-6924
- NPI assigned
- Oct 29, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | WA | Primary |
Addresses
Primary practice location
516 176TH St E
Spanaway, WA 98387-8335
Mailing address
3037 S 154TH St
Apt: A108
Seatac, WA 98188-2145
Phone (206) 257-9251
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 426607H | Other | WA | WASHINGTON STATE EDUCATION CERTIFICATE INITIAL ESA |
| LL60265399 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1740534825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3037 S 154TH ST",
"address_2": "APT: A108",
"city": "SEATAC",
"state": "WA",
"postal_code": "981882145",
"telephone_number": "206-257-9251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 176TH ST E",
"city": "SPANAWAY",
"state": "WA",
"postal_code": "983878335",
"telephone_number": "253-683-6924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGALLA",
"first_name": "KALYAN",
"name_prefix": "Mr.",
"credential": "SPEECH THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-29",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE EDUCATION CERTIFICATE INITIAL ESA",
"identifier": "426607H",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
"identifier": "LL60265399",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spanaway, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.