MEDICARE: UNIVERSITY OF KANSAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1851266118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF KANSAS

Provider Business Mailing Address
First Line	:	1200 SUNNYSIDE AVE
Second Line	:	2101 HAWORTH HALL
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7600
Country	:	US
Telephone Number	:	785-864-4690
Fax Number	:	785-864-5094

Provider Business Practice Location Address
First Line	:	1200 SUNNYSIDE AVE
Second Line	:	2101 HAWORTH HALL
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7600
Country	:	US
Telephone Number	:	785-864-4690
Fax Number	:	785-864-5094

Authorized Official
Title or Position	:	CLINIC MANAGER
Name	:	SARAH ROSE DOMINGOS
Credential	:	M.A.
Telephone Number	:	785-864-4690

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	10/07/2025

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Directions to “UNIVERSITY OF KANSAS ” Practice Location

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