Individual provider Active NPI

Katie Lynn McGraw, MS CCCSLP

  • Speech-Language Pathologist
  • Portland, ME
National Provider Identifier
1801932777
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1506 Issued in ME
Practice address
43 Baxter Blvd
Portland, ME 04101-1823
Phone
(207) 874-1065
Fax
(207) 874-1068
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SP1506 ME Primary

Addresses

Primary practice location

43 Baxter Blvd
Portland, ME 04101-1823

Mailing address

43 Baxter Blvd
Northeast Hearing & Speech Center Inc
Portland, ME 04101-1823
Phone (207) 874-1065

Other identifiers 1

IdentifierTypeStateIssuer
047480OtherMEANTHEM BCBS

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

LicenseStateTypeSpecialty
SP1506MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801932777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 BAXTER BLVD",
            "address_2": "NORTHEAST HEARING & SPEECH CENTER INC",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011823",
            "telephone_number": "207-874-1065",
            "fax_number": "207-874-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011823",
            "telephone_number": "207-874-1065",
            "fax_number": "207-874-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MS CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP1506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "047480",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.