Nicole Lynn Kavanagh, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP6798 Issued in AZ

Practice address

5783 S Fawn Ave
Gilbert, AZ 85298-0848

Phone

(480) 518-7073

NPI assigned

Jun 3, 2010

Last updated

Aug 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• NK Speech Therapy and Behavior Support PLLC

  • Hearing and Speech Clinic/Center
  • Phoenix, AZ
  • NPI 1104561471

  Single Specialty

  Medicare reassignment NPD Authorized official
• Healthy Brain Aging, LLC

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1700437506

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1922328780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5783 S FAWN AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980848",
            "telephone_number": "480-518-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5783 S FAWN AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980848",
            "telephone_number": "480-518-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018711",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP6798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Kauffman, LMT
• Andrew J Kaufmann, ND
• Gurpreet Kaur, DMD
• Claire Kaura, M.D.
• Rick J Kautz, RPH
• Kays Family Healthcare PLLC
• Penny Kayton, M.S., CCC-SLP
• Katharine A Kazaka, NP
• Katrina Marie Kazandjian
• Manar Kazar

• Speech-Language Pathologist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.