Active NPI
Kelsey Anne Holder, MS CCC-SLP
- Speech-Language Pathologist
- Windermere, FL
National Provider Identifier
1053880013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA16658
- Practice address
- 12050 Overstreet Rd
Windermere, FL 34786-6666 - NPI assigned
- Nov 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA16658 | FL | Primary |
Addresses
Primary practice location
12050 Overstreet Rd
Windermere, FL 34786-6666
Mailing address
106 Inland Seas Blvd
Winter Garden, FL 34787-2505
Phone (407) 451-3987
Other practice location 1
214 S Dillard St
Winter Garden, FL 34787-3523
Phone (407) 877-0029
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA16658 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542672000000",
"number": "1053880013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 INLAND SEAS BLVD",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347872505",
"telephone_number": "407-451-3987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12050 OVERSTREET RD",
"city": "WINDERMERE",
"state": "FL",
"postal_code": "347866666"
}
],
"practiceLocations": [
{
"address_1": "214 S Dillard St",
"address_purpose": "LOCATION",
"city": "Winter Garden",
"state": "FL",
"postal_code": "347873523",
"country_code": "US",
"telephone_number": "407-877-0029",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLDER",
"first_name": "KELSEY",
"middle_name": "ANNE",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-20",
"last_updated": "2018-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA16658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windermere, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.