Active NPI
Elizabeth Jordan Kennedy, MS, CCC-SLP
- Speech-Language Pathologist
- Wilmington, DE
National Provider Identifier
1073862504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 0585
- Practice address
- 1502 Spruce Ave
Wilmington, DE 19805-2148 - Phone
- (302) 552-3700
- NPI assigned
- Aug 30, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 01-0001378 | DE | |
| Speech-Language Pathologist | 235Z00000X | 0585 | WV | Primary |
Addresses
Primary practice location
1502 Spruce Ave
Wilmington, DE 19805-2148
Mailing address
501 22ND St
Dunbar, WV 25064-1711
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 |
|---|---|---|---|
| 01-0001378 | DE | MD | Speech-Language Pathologist |
| 0585 | WV | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kanawha County Schools | Past | Accepting new patients | |
| Kanawha County Schools | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Charleston, WV
- NPI 1205035334
-
- Local Education Agency (LEA)
- Charleston, WV
- NPI 1407026636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1073862504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 22ND ST",
"city": "DUNBAR",
"state": "WV",
"postal_code": "250641711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 SPRUCE AVE",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198052148",
"telephone_number": "302-552-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "ELIZABETH",
"middle_name": "JORDAN",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DE",
"license": "01-0001378",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "0585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.