Active NPI
Kelley Harris, M.S., CCC-SLP
- Speech-Language Pathologist
- Saint Louis, MO
National Provider Identifier
1013259928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2005005715
- Practice address
- 11541 Rosary LN
Saint Louis, MO 63138-1738 - Phone
- (314) 591-4696
- NPI assigned
- Mar 19, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2005005715 | MO | Primary |
Addresses
Primary practice location
11541 Rosary LN
Saint Louis, MO 63138-1738
Mailing address
11541 Rosary LN
Saint Louis, MO 63138-1738
Phone (314) 591-4696
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005005715 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1013259928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11541 ROSARY LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631381738",
"telephone_number": "314-591-4696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11541 ROSARY LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631381738",
"telephone_number": "314-591-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KELLEY",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-19",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2005005715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.