Kelly Marie Davidson, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10218 Issued in OH

Practice address

10098 Big Bear Creek Rd
Lucasville, OH 45648-9168

Phone

(740) 259-5536

NPI assigned

Feb 5, 2011

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

Other names 1

• Mrs. Kelly M Davidson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1296864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1053617282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 CHURCH ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456012406",
            "telephone_number": "708-372-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10098 BIG BEAR CREEK RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456489168",
            "telephone_number": "740-259-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-05",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "10218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DAVIDSON",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "M.S., CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Oran Lee Crabtree, RN
• Renauta Lee Crabtree
• Edith D Crager, RN
• Pamela Gail Creed, LICDC-CS
• Dannis Elite Home Care, LLC
• Armanda Davis
• Janel Lynn Davis, OTR/L
• James J Devins Jr.
• Angela Lauren Dodridge
• Nicole Renee Dodridge

• Speech-Language Pathologist in Lucasville, OH
• Providers in Lucasville, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.