Individual provider Active NPI

Dorothy Ann Kelly, SLP

  • Speech-Language Pathologist
  • Dobbs Ferry, NY
National Provider Identifier
1053563395
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
000668-1 Issued in NY
Practice address
63 Livingston Ave
3Rd Floor
Dobbs Ferry, NY 10522-2826
Phone
(914) 231-5014
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 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 000668-1 NY Primary

Addresses

Primary practice location

63 Livingston Ave
3Rd Floor
Dobbs Ferry, NY 10522-2826

Mailing address

63 Livingston Ave
3Rd Floor
Dobbs Ferry, NY 10522-2826
Phone (914) 231-5014

Other identifiers 1

IdentifierTypeStateIssuer
KELO769MedicaidNY

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
000668-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1053563395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 LIVINGSTON AVE",
            "address_2": "3RD FLOOR",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222826",
            "telephone_number": "914-231-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 LIVINGSTON AVE",
            "address_2": "3RD FLOOR",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222826",
            "telephone_number": "914-231-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DOROTHY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "000668-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KELO769",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dobbs Ferry, NY

Sources for this page

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