Active NPI
Taylor Kelly, CCC-SLP
- Speech-Language Pathologist
- California, MD
National Provider Identifier
1083063721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 08134
- Practice address
- 22593 Three Notch Rd
California, MD 20619-3054 - Phone
- (301) 862-2505
- Fax
- (301) 862-2548
- NPI assigned
- Jun 3, 2016
- 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 | 08134 | MD | Primary |
Addresses
Primary practice location
22593 Three Notch Rd
California, MD 20619-3054
Mailing address
22593 Three Notch Rd
California, MD 20619-3054
Phone (301) 862-2505
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08134 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1083063721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22593 THREE NOTCH RD",
"city": "CALIFORNIA",
"state": "MD",
"postal_code": "206193054",
"telephone_number": "301-862-2505",
"fax_number": "301-862-2548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22593 THREE NOTCH RD",
"city": "CALIFORNIA",
"state": "MD",
"postal_code": "206193054",
"telephone_number": "301-862-2505",
"fax_number": "301-862-2548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "TAYLOR",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-03",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "08134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in California, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.