Active NPI
Kaycie VB King, CCC-SLP
- Speech-Language Pathologist
- Indianapolis, IN
National Provider Identifier
1962692459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22005035A
- Practice address
- 4740 Kingsway Dr Ste 33
Indianapolis, IN 46205-1521 - Phone
- (317) 828-0211
- Fax
- (888) 887-0932
- NPI assigned
- Jul 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 22005035A | IN | Primary |
Addresses
Primary practice location
4740 Kingsway Dr Ste 33
Indianapolis, IN 46205-1521
Mailing address
4740 Kingsway Dr Ste 33
Indianapolis, IN 46205-1521
Phone (317) 828-0211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200859350 A | Other | IN | LEGACY PROVIDER IDENTIFIE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22005035A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1962692459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 KINGSWAY DR STE 33",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462051521",
"telephone_number": "317-828-0211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 KINGSWAY DR STE 33",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462051521",
"telephone_number": "317-828-0211",
"fax_number": "888-887-0932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KAYCIE",
"middle_name": "VB",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-31",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22005035A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LEGACY PROVIDER IDENTIFIE",
"identifier": "200859350 A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.