Kelli Banta

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

4805 W 4TH St
Hattiesburg, MS 39402-1019

Phone

(601) 270-6968

NPI assigned

Jun 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Aultman Speech Therapy Services, LLC

  • Speech-Language Pathologist
  • Sumrall, MS
  • NPI 1912154220
  NPD (past)

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1003591769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 CONCART ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394014213",
            "telephone_number": "504-701-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 W 4TH ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021019",
            "telephone_number": "601-270-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTA",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Diane Browning Ball, PHARM D.
• Keerthi Banda, M.D.
• Ambrea Kaitlyn Banks, MS, RD, LDN
• Austin Banks
• Kirk J Banquer, M.D.
• Evelyn Barajas
• Mary Catherine Barbato
• Ellen E Barber-Wallace, MS
• Corinne R Barbieri, CRNA
• Rocco A Barbieri, M.D.,

• Speech-Language Pathologist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.