Individual provider Active NPI

Kelley Jean Rohrborn

  • Speech-Language Pathologist
  • Margate, FL
National Provider Identifier
1033504949
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA17657 Issued in FL
Practice address
6344 Duval Dr
Margate, FL 33063
Phone
(805) 843-5941
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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 22350 CA
Speech-Language Pathologist 235Z00000X SA17657 FL Primary

Addresses

Primary practice location

6344 Duval Dr
Margate, FL 33063

Mailing address

6344 Duval Dr
Margate, FL 33063
Phone (805) 843-5941

Other names 1

  • Kelley Jean Keating Former name

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
SA17657FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom of Speech Therapy Center, LLC Speech-Language Pathologist CurrentSince Jul 5, 2020 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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1033504949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6344 DUVAL DR",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "33063",
            "telephone_number": "805-843-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6344 DUVAL DR",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "33063",
            "telephone_number": "805-843-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHRBORN",
        "first_name": "KELLEY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "22350",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "KEATING",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Margate, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.