Katherine Ann Phelan, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101000610 Issued in MI

Practice address

3041 Commerce Dr Ste a
Fort Gratiot, MI 48059-3877

Phone

(810) 990-8644

NPI assigned

Sep 16, 2013

Last updated

Sep 16, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1063848513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 COMMERCE DR STE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 COMMERCE DR STE A",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593877",
            "telephone_number": "810-990-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Rose Peltz, LMSW
• Jerrie Michele Pemberton, OTR
• Amanda Michelle Penley
• Marie Peterson, OD
• Jennifer Ann Peyerk, P.T.
• Phillip a. Kohanov O.D. PC
• Physician Healthcare Network, PC
• Bailey Piacentini
• Katherine Bernadette Pizzo
• Placed on Purpose

• Speech-Language Pathologist in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.