Khalil Sumlin

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9083 Issued in LA

Practice address

650 Olive St
Shreveport, LA 71104-2210

Phone

(318) 302-6000

NPI assigned

Jan 21, 2020

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Riley Physical Therapy, Inc

  • Physical Therapist
  • Shreveport, LA
  • NPI 1356814826

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1992335731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 EILEEN LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711092022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 OLIVE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042210",
            "telephone_number": "318-302-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMLIN",
        "first_name": "KHALIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-21",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "9083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miyoshi Umeakiiretta Sullivan
• Regina Galloway Sullivan
• Muhammad Junaid Sultan, MD
• Nazifa Sultana, AU. D.
• Dana Sumbler, NURSE PRACTITIONER
• Magdalene Sumlin
• Shenita Hall Sumlin
• Danielle Summage
• Summer Grove Counseling Services LLC
• Amy Sun, D.D.S.

• Speech-Language Pathologist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.