Active NPI
Kyren Griebel, MS, CCC-SLP
- Speech-Language Pathologist
- Fort Wayne, IN
National Provider Identifier
1801345442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22006435A
- Practice address
- 4422 E State Blvd
Fort Wayne, IN 46815-6917 - Phone
- (260) 471-9263
- Fax
- (765) 450-6664
- NPI assigned
- Sep 23, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 22006435A | IN | Primary |
Addresses
Primary practice location
4422 E State Blvd
Fort Wayne, IN 46815-6917
Mailing address
700 E Firmin Street
Suite 209
Kokomo, IN 46902-2375
Phone (765) 454-9748
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22006435A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1801345442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 E FIRMIN STREET",
"address_2": "SUITE 209",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469022375",
"telephone_number": "765-454-9748",
"fax_number": "765-450-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 E STATE BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468156917",
"telephone_number": "260-471-9263",
"fax_number": "765-450-6664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIEBEL",
"first_name": "KYREN",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22006435A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.