Individual provider Active NPI

Keira June Oblenis, SLP

  • Speech-Language Pathologist
  • West Lafayette, IN
National Provider Identifier
1801493390
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
220007462A Issued in IN
Practice address
1700 Lindberg Rd
West Lafayette, IN 47906-7317
Phone
(765) 464-5655
Fax
(765) 464-5654
NPI assigned
Oct 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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 220007462A IN Primary

Addresses

Primary practice location

1700 Lindberg Rd
West Lafayette, IN 47906-7317

Mailing address

1700 Lindberg Rd
West Lafayette, IN 47906-7317
Phone (765) 464-5655

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
220007462AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1801493390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 LINDBERG RD",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479067317",
            "telephone_number": "765-464-5655",
            "fax_number": "765-464-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 LINDBERG RD",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479067317",
            "telephone_number": "765-464-5655",
            "fax_number": "765-464-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBLENIS",
        "first_name": "KEIRA",
        "middle_name": "JUNE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "220007462A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.