Kaitlin O'Sullivan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL012091 Issued in PA

Practice address

2122 Spruce St Apt 301
Philadelphia, PA 19103-2556

Phone

(585) 339-8062

NPI assigned

Oct 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Kaitlin Ruffolo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1750786935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 SPRUCE ST APT 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032556",
            "telephone_number": "585-339-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 SPRUCE ST APT 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032556",
            "telephone_number": "585-339-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "KAITLIN",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "RUFFOLO",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charles T O'Shea, R.PH.
• Gabriela O'Shea, M.ED
• Jessica Elizabeth O'Shea, MD
• Noelle Anneliese O'Shea, APRN-BC
• Brian O'Sullivan, MS, OTR/L
• Martin James O'Sullivan, MD
• Patrick O'Toole, M.D.
• Samantha O'Toole, R.D.
• O2S LLC
• Oak Lane Pharmacy Inc

• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.