Kenyetta Booker
NPI 1558107714ActiveIndividual· Speech-Language Pathologist· Rogers, MN
Speech-Language Pathologist with Aegis Group Practice LLC, practicing in Rogers, Minnesota. Enrolled in Medicare as practitioner - qualified speech language pathologist and practitioner - qualified speech language pathologist.
Overview
| NPI | 1558107714 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jul 6, 2024 |
| Last updated in NPPES | Jan 19, 2026 |
| Certified by provider | Jan 19, 2026 |
| Reactivated | May 29, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 529084 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (LA); Practitioner - Qualified Speech Language Pathologist (MN) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
Medical group
- Aegis Group Practice LLCToledo, OH · 390 clinicians
Other speech-language pathologists in Rogers
- 1588720817
- 1053024323
- 1902159841