Individual provider Active NPI

Kesha Nacole Boyles

  • Speech-Language Pathologist
  • Dallas, TX
National Provider Identifier
1003578162
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
119070 Issued in TX
Practice address
14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856
Phone
(866) 919-3240
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 119070 TX Primary

Addresses

Primary practice location

14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856

Mailing address

15190 Prestonwood Blvd Apt 823
Dallas, TX 75248-4736
Phone (870) 784-0190

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

State licenses

LicenseStateTypeSpecialty
119070TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1003578162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15190 PRESTONWOOD BLVD APT 823",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752484736",
            "telephone_number": "870-784-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548856",
            "telephone_number": "866-919-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLES",
        "first_name": "KESHA",
        "middle_name": "NACOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "119070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.