Active NPI
Julie Lynn Kogut, MA, CCC-SLP
- Speech-Language Pathologist
- Valrico, FL
National Provider Identifier
1902921091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA4020
- Practice address
- 4331 Lynx Paw TRL
Valrico, FL 33594-7426 - Phone
- (813) 684-0800
- Fax
- (813) 684-0811
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
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 | SA4020 | FL | Primary |
Addresses
Primary practice location
4331 Lynx Paw TRL
Valrico, FL 33594-7426
Mailing address
4702 Water Lark Way
Valrico, FL 33594-7939
Phone (813) 368-2485
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SA0420 | Medicaid | FL |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA4020 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902921091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4702 WATER LARK WAY",
"city": "VALRICO",
"state": "FL",
"postal_code": "335947939",
"telephone_number": "813-368-2485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4331 LYNX PAW TRL",
"city": "VALRICO",
"state": "FL",
"postal_code": "335947426",
"telephone_number": "813-684-0800",
"fax_number": "813-684-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOGUT",
"first_name": "JULIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA4020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SA0420",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valrico, FL
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.