Individual provider Active NPI

Kynda Ray, MS CCC SLP

  • Speech-Language Pathologist
  • Tarpon Springs, FL
National Provider Identifier
1851439467
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14334 Issued in FL
Practice address
636 N Lake Blvd
Tarpon Springs, FL 34689-5247
Phone
(618) 599-0743
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22002594A IN
Speech-Language Pathologist 235Z00000X SA14334 FL Primary

Addresses

Primary practice location

636 N Lake Blvd
Tarpon Springs, FL 34689-5247

Mailing address

636 N Lake Blvd
Tarpon Springs, FL 34689-5247
Phone (618) 599-0743

Other practice location 1

RR 3 Box 947
Fairfield, IL 62837-9036
Phone (618) 599-0743

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA14334FLMDSpeech-Language Pathologist
22002594AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851439467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 N LAKE BLVD",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895247",
            "telephone_number": "618-599-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 N LAKE BLVD",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895247",
            "telephone_number": "618-599-0743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "RR 3 Box 947",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "IL",
            "postal_code": "628379036",
            "country_code": "US",
            "telephone_number": "618-599-0743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "KYNDA",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002594A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.