Kelli Ann Travis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1592 Issued in NE

Practice address

701 S Main St (Broken Arrow Public Schools-Special Serv
Broken Arrow, OK 74012

Phone

(918) 259-5700

Fax

(918) 455-2588

NPI assigned

Mar 12, 2014

Last updated

Sep 21, 2018By 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

Other names 1

• Ms. Kelli Ann Rollen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1073939260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S MAIN ST (BROKEN ARROW PUBLIC SCHOOLS-SPECIAL SERV",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-259-5700",
            "fax_number": "918-455-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S MAIN ST (BROKEN ARROW PUBLIC SCHOOLS-SPECIAL SERV",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74012",
            "telephone_number": "918-259-5700",
            "fax_number": "918-455-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-12",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "ROLLEN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.

Verify at the official NPI Registry.