Kelly R. Sosebee, MHE,SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005612 Issued in GA

Practice address

162 Abba Rd
Fitzgerald, GA 31750-6047

Phone

(706) 589-3773

Fax

(803) 202-0334

NPI assigned

Jun 30, 2009

Last updated

Jun 30, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Augusta Therapy Services for Children

  • Pediatric Occupational Therapist
  • North Augusta, SC
  • NPI 1346430329

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1043448962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12094",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309142094",
            "telephone_number": "706-589-3773",
            "fax_number": "803-202-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 ABBA RD",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317506047",
            "telephone_number": "706-589-3773",
            "fax_number": "803-202-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSEBEE",
        "first_name": "KELLY",
        "middle_name": "R.",
        "credential": "MHE,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smile Mission Fitzgerald LLC
• Anna Nicole Smith
• John Smith
• Judith Elaine Smith, M.DIV
• Lynne D Smith, F.N.P.-C
• South Central Primary Care Center, Inc (Kids Health Fitzgerald)
• South Central Primary Care Center, Inc (Ben Hill County School Health Center)
• South Central Primary Care Center, Inc (Hurricane Health Center 2)
• South Central Primary Care Center, Inc
• South Georgia Mental Healthcare, LLC

• Speech-Language Pathologist in Fitzgerald, GA
• Providers in Fitzgerald, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.