Active NPI
Kaitlin Flynn
- Speech-Language Pathologist
- North Liberty, IA
National Provider Identifier
1932682267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 088612
- Practice address
- 1210 Jordan St
North Liberty, IA 52317-8031 - Phone
- (319) 626-2553
- NPI assigned
- Sep 12, 2018
- Last updated
- Sep 12, 2018
- 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 | 088612 | IA | Primary |
Addresses
Primary practice location
1210 Jordan St
North Liberty, IA 52317-8031
Mailing address
807 N 1St Ave
Iowa City, IA 52245-3508
Phone (618) 978-7763
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 088612 | IA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536710400000",
"number": "1932682267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 N 1ST AVE",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522453508",
"telephone_number": "618-978-7763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 JORDAN ST",
"city": "NORTH LIBERTY",
"state": "IA",
"postal_code": "523178031",
"telephone_number": "319-626-2553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "KAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-12",
"last_updated": "2018-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "088612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Liberty, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.