Active NPI
Caitlin G Sears, SLP-CCC
- Speech-Language Pathologist
- Goshen, IN
National Provider Identifier
1821695115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22006124A
- Practice address
- 1640 Autumn Blaze LN
Goshen, IN 46526-7000 - Phone
- (317) 653-5767
- NPI assigned
- Oct 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 22006124A | IN | Primary |
Addresses
Primary practice location
1640 Autumn Blaze LN
Goshen, IN 46526-7000
Mailing address
1502 Cedar St
South Bend, IN 46617-2532
Phone (717) 341-5373
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22006124A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1821695115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 CEDAR ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172532",
"telephone_number": "717-341-5373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 AUTUMN BLAZE LN",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465267000",
"telephone_number": "317-653-5767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEARS",
"first_name": "CAITLIN",
"middle_name": "G",
"credential": "SLP-CCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22006124A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.