Individual provider Active NPI

Kathryn M Hecklinski

  • Speech-Language Pathologist
  • Mishawaka, IN
National Provider Identifier
1760125165
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1215 Trinity PL
Mishawaka, IN 46545-5000
Phone
(317) 204-3736
NPI assigned
Apr 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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 Primary

Addresses

Primary practice location

1215 Trinity PL
Mishawaka, IN 46545-5000

Mailing address

52768 Red Fox TRL
South Bend, IN 46628-9252
Phone (574) 993-3836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220418001614 IN Practitioner - Qualified Speech Language Pathologist 6103213327 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serene Stays LLCGroup PAC ID 0749784692, 2 clinicians

Practice addresses (Care Compare)

South Bend, IN 46628
Phone (574) 404-1524

343 E 90TH Dr
Merrillville, IN 46410-8152
Phone (219) 207-6100

4010 S Ironwood Dr
Vertis Therapy|Grand Emerald
South Bend, IN 46614-2200
Phone (574) 216-4510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Apr 1, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Dec 28, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Dec 28, 2024 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Apr 1, 2022 Accepting new patients

Locations

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

1540 S Logan St
Mishawaka, IN 46544
Phone (574) 207-0833

1215 Trinity Pl
Mishawaka, IN 46545
Phone (574) 247-7400

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 5

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": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1760125165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52768 RED FOX TRL",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289252",
            "telephone_number": "574-993-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 TRINITY PL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465455000",
            "telephone_number": "317-204-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKLINSKI",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.