Kelley Elizalde

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

505 S Main St
Joshua, TX 76058-3310

Phone

(817) 202-2500

NPI assigned

Aug 8, 2022

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 8, 2022.

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1033846191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808 STOCKTON DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761325007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST",
            "city": "JOSHUA",
            "state": "TX",
            "postal_code": "760583310",
            "telephone_number": "817-202-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZALDE",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gene Thomas Dewitt, DDS
• Deborah Duval, L.AC.
• Kourtney East, OTR
• Marcy D Easter, M.S.CCC-SLP
• Desola Mary Efunshile, NURSE
• Kiara Erazo, APRN-CNP
• First Lone Star Pharmacy Group III LLC
• Ailey Ann Folsom, RN, FNP-C
• Russell Daniel Gardner, RPH
• Stephanie Geis, LCSW

• All providers in Joshua, TX
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.