Louise Ellen Kelly, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2064 Issued in NC

Practice address

125 Baldwin Ave
Suite 100
Charlotte, NC 28204-3364

Phone

(704) 316-1900

Fax

(704) 316-1924

NPI assigned

Apr 14, 2010

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

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 and National Provider Directory roles.

• Foundation Health Systems LLC

  • Physical Therapy Clinic/Center
  • Winston Salem, NC
  • NPI 1205894029

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1114243243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BALDWIN AVE",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043364",
            "telephone_number": "704-316-1900",
            "fax_number": "704-316-1924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2711 Randolph Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072027",
            "country_code": "US",
            "telephone_number": "980-302-8271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LOUISE",
        "middle_name": "ELLEN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "2064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Ann Kelly, LPC
• Joseph Kelly
• Karyn Kelly, BCBA
• Katherine Kelly, NP
• Lisa Kelly, RN-MSN, FNP-C
• Marion Randy Kelly Jr., MSN, APRN, FNP-BC
• Mary Kelly, OT/L
• Melissa Marie Kelly, PA
• Monica Susan Kelly, CRNA
• Nancy Chandale Kelly

• Speech-Language Pathologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.

Verify at the official NPI Registry.