Individual provider Active NPI

Kathryn Laine Buczek

  • Speech-Language Pathologist
  • Centennial, CO
National Provider Identifier
1760049167
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PSLP.0000493 Issued in CO
Practice address
6970 S Holly Cir
Centennial, CO 80112-6296
Phone
(720) 287-4185
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2019

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 PSLP.0000493 CO Primary

Addresses

Primary practice location

6970 S Holly Cir
Centennial, CO 80112-6296

Mailing address

1151 Ivy Farm Way
Amelia, OH 45102-1250
Phone (513) 368-2341

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
PSLP.0000493COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1760049167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 IVY FARM WAY",
            "city": "AMELIA",
            "state": "OH",
            "postal_code": "451021250",
            "telephone_number": "513-368-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 S HOLLY CIR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126296",
            "telephone_number": "720-287-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZEK",
        "first_name": "KATHRYN",
        "middle_name": "LAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "PSLP.0000493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.