Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenyetta Booker

Individual provider Speech-Language Pathologist · NPI 1558107714

Kenyetta Booker is a Qualified Speech Language Pathologist in Rogers, Minnesota. Qualified in 2014, 12 years ago. Practices with Aegis Group Practice LLC, a 406-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
12
Licensed in
MN
In the registry since
2024

Practice location Address checks out

13650 Marsh View Blvd Apt 102
Rogers, MN 55374-6034
Phone: (318) 302-9192
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 529084 (MN)

Record details

NPI number1558107714
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 6, 2024
Last updated in NPPESJanuary 19, 2026
Certification dateJanuary 19, 2026
Mailing address13650 Marsh View Blvd Apt 102, Rogers, MN 55374-6034

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Aegis Group Practice Llc — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rogers