Kelli De Waard, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

558-PROV Issued in SD

Practice address

1216 N Garfield Ave
Dell Rapids, SD 57022-1837

Phone

(605) 428-5473

NPI assigned

Jun 8, 2016

Last updated

Jun 8, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dell Rapids School District 49-3

  • Local Education Agency (LEA)
  • Dell Rapids, SD
  • NPI 1891879359
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1073962346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6509 W ALYSSUM ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571071605",
            "telephone_number": "605-261-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 N GARFIELD AVE",
            "city": "DELL RAPIDS",
            "state": "SD",
            "postal_code": "570221837",
            "telephone_number": "605-428-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE WAARD",
        "first_name": "KELLI",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SD",
            "license": "558-PROV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avera McKennan (Avera Dells Area Hospital Swingbed)
• Alec Michael Baker, PA-C
• Chirosport Dell Rapids PC
• City of Dell Rapids
• Bethany Crisp, MSW, CSW-PIP
• Dell Rapids Community Ambulance Service
• Dell Rapids Community Ambulance Service
• Dell Rapids Dental
• Dell Rapids NRSG. Home Inc. (terrace Manor)
• Dell Rapids Nursing Home (Terrace Manor)

• Speech-Language Pathologist in Dell Rapids, SD
• Providers in Dell Rapids, SD by specialty
• Speech-Language Pathologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.