Individual provider Active NPI

Kara Landis, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Indianapolis, IN
National Provider Identifier
1790807105
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22003669A Issued in IN
Practice address
1920 Alvee Cir
Indianapolis, IN 46239-8779
Phone
(317) 357-0635
Fax
(317) 354-8721
NPI assigned
Apr 4, 2007
Last updated
May 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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 22003669A IN Primary

Addresses

Primary practice location

1920 Alvee Cir
Indianapolis, IN 46239-8779

Mailing address

PO Box 39221
Indianapolis, IN 46239-0221
Phone (317) 357-0635

Other practice location 1

1613 W Riverside Ave
Muncie, IN 47306-8779
Phone (765) 285-4422

Other identifiers 3

IdentifierTypeStateIssuer
200672280OtherINRENDERING PROVIDER NUMBER
200535880MedicaidIN
200725890AOtherINPROVIDER GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230713001355 IN Practitioner - Qualified Speech Language Pathologist 4486014123 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Ball State UniversityGroup PAC ID 9830577220, 10 clinicians

Practice addresses (Care Compare)

1613 W Riverside Ave
Interprofessional Community Clinics
Muncie, IN 47303-3547
Phone (765) 285-4422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22003669AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Jul 1, 2023 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Ball State University Speech-Language Pathologist CurrentSince Aug 17, 2023 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jun 7, 2023 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Jul 1, 2023 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jun 7, 2023 Accepting new patients

Locations

2335 N Madison Ave
Anderson, IN 46011
Phone (765) 610-8996

11570 E 126th St
Fishers, IN 46037
Phone (317) 349-5913

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

98 N 10th St
Greencastle, IN 46135
Phone (765) 301-4642

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1790807105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39221",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462390221",
            "telephone_number": "317-357-0635",
            "fax_number": "317-354-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 ALVEE CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462398779",
            "telephone_number": "317-357-0635",
            "fax_number": "317-354-8721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1613 W Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473068779",
            "country_code": "US",
            "telephone_number": "765-285-4422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "KARA",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003669A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING PROVIDER NUMBER",
            "identifier": "200672280",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200535880",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER GROUP NUMBER",
            "identifier": "200725890A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.