CMS-1500 Box 24J / 33a • NPI
1104709104
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
235Z00000X (CMS 15)
Licensed & Credentialed Speech, Language and Hearing Service Providers
Box 32 Service Location & ZIP+4
202 W 7TH ST STE 203, LONDON, KY, 40741-1763
✓ 9-Digit EDI 837 ZIP+4 (40741-1763)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1104709104 (BLUEGRASS SPEECH & SWALLOWING OUTPATIENT THERAPY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1104709104 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BLUEGRASS SPEECH & SWALLOWING OUTPATIENT THERAPY LLC |
| Plain-English Specialty | Licensed & Credentialed Speech, Language and Hearing Service Providers NUCC Code: 235Z00000X (Speech-Language Pathologist, ) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 202 W 7TH ST STE 203, LONDON, KY, 40741-1763 |
| Practice Telephone / Fax | Tel: (606) 309-4982 |
| Administrative Mailing Address | 452 BRANNON MILL RD, LILY, KY, 40740-3504 |
| Enumeration & Last Sync | Enumerated: 2025-07-28 | CMS Record Updated: 2026-08-19 |
| Authorized Official | KAILYN BAKER (Owner/Speech Language Pathologist) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (235Z00000X)
What Does Taxonomy Code 235Z00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 235Z00000X translates to:
"Licensed & Credentialed Speech, Language and Hearing Service Providers"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BLUEGRASS SPEECH & SWALLOWING OUTPATIENT THERAPY LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103K00000X — Behavior AnalystPlain English: Licensed & Credentialed Behavior Analyst | State: N/A | License: Verified | Primary: Secondary |
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: N/A | License: Verified | Primary: Secondary |
225200000X — Physical Therapy AssistantPlain English: Licensed & Credentialed Physical Therapy Assistant | State: N/A | License: Verified | Primary: Secondary |
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
235Z00000X — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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