Individual provider Active NPI

Kelsey Rose Nobles, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Warsaw, NY
National Provider Identifier
1043982135
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
62 Prospect St
Warsaw, NY 14569-1533
Phone
(585) 397-4079
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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 033394 NY
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

62 Prospect St
Warsaw, NY 14569-1533

Mailing address

102 East Ave
Wayland, NY 14572-1106
Phone (585) 397-4079

Other names 1

  • Miss Kelsey Rose Burke 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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1043982135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 EAST AVE",
            "city": "WAYLAND",
            "state": "NY",
            "postal_code": "145721106",
            "telephone_number": "585-397-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 PROSPECT ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691533",
            "telephone_number": "585-397-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLES",
        "first_name": "KELSEY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "033394",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "BURKE",
            "middle_name": "ROSE",
            "prefix": "MISS",
            "credential": "M.S. CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warsaw, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.