Individual provider Active NPI

Kelsey Conlan O'Boyle, M.ED., CCC-SLP

  • Speech-Language Pathologist
  • Charlottesville, VA
National Provider Identifier
1003430646
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202010039 Issued in VA
Practice address
1102 Rose Hill Dr
Charlottesville, VA 22903-5128
Phone
(434) 979-8628
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP.0004458 CO
Speech-Language Pathologist 235Z00000X 2202010039 VA Primary

Addresses

Primary practice location

1102 Rose Hill Dr
Charlottesville, VA 22903-5128

Mailing address

937 Fir St
Waynesboro, VA 22980-3753
Phone (434) 260-1858

Other practice location 1

937 Fir St
Waynesboro, VA 22980-3753
Phone (540) 946-4626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
SLP.0004458COMDSpeech-Language Pathologist
2202010039VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charleston Center, Inc Speech-Language Pathologist PastSince Dec 3, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1003430646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 FIR ST",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803753",
            "telephone_number": "434-260-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 ROSE HILL DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229035128",
            "telephone_number": "434-979-8628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "937 Fir St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "VA",
            "postal_code": "229803753",
            "country_code": "US",
            "telephone_number": "540-946-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BOYLE",
        "first_name": "KELSEY",
        "middle_name": "CONLAN",
        "name_prefix": "Ms.",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-11-28",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0004458",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.