Individual provider Active NPI

Karen Eileen Kozy-Landress, M.ED., M.A., CCC-SLP

  • Speech-Language Pathologist
  • Merritt Island, FL
National Provider Identifier
1861409930
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA-5827 Issued in FL
Practice address
1327 George Edwards CT
Merritt Island, FL 32953-4458
Phone
(321) 537-8762
Fax
(321) 452-0134
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 SA-5827 FL Primary

Addresses

Primary practice location

1327 George Edwards CT
Merritt Island, FL 32953-4458

Mailing address

1327 George Edwards CT
Merritt Island, FL 32953-4458
Phone (321) 537-8762

Other identifiers 1

IdentifierTypeStateIssuer
830045300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200515002381 FL Practitioner - Qualified Speech Language Pathologist 2567893019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13810 Sheldon Rd
Tampa, FL 33626-3619
Phone (813) 820-5908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Education

State licenses

LicenseStateTypeSpecialty
SA-5827FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Apr 12, 2020 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Apr 12, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861409930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 GEORGE EDWARDS CT",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534458",
            "telephone_number": "321-537-8762",
            "fax_number": "321-452-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 GEORGE EDWARDS CT",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534458",
            "telephone_number": "321-537-8762",
            "fax_number": "321-452-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZY-LANDRESS",
        "first_name": "KAREN",
        "middle_name": "EILEEN",
        "credential": "M.ED., M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA-5827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830045300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.