Individual provider Active NPI

Kelsey Callison

  • Speech-Language Pathologist
  • Hancock, MI
National Provider Identifier
1033518170
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101004402 Issued in MI
Practice address
1400 Poplar St
Hancock, MI 49930-1121
Phone
(989) 339-0606
NPI assigned
Aug 14, 2014
Last updated
Aug 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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 7101004402 MI Primary

Addresses

Primary practice location

1400 Poplar St
Hancock, MI 49930-1121

Mailing address

1400 Poplar St
Hancock, MI 49930-1121
Phone (989) 339-0606

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
7101004402MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1033518170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 POPLAR ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301121",
            "telephone_number": "989-339-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 POPLAR ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301121",
            "telephone_number": "989-339-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISON",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.