Matthew Todd Kelly, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

C-4614 Issued in NM

Practice address

1919 5TH St
Santa Fe, NM 87505-5402

Phone

(505) 204-8919

NPI assigned

Feb 25, 2010

Sex

Male

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

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1114249646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PRAIRIE CREST DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875081314",
            "telephone_number": "505-204-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 5TH ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055402",
            "telephone_number": "505-204-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MATTHEW",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-25",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "C-4614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia J Kelley, LISW
• Margaret E. Kelley, LPCC
• Hunter Kelly
• Marcos Kelly, LMT
• Matthew J Kelly, M.D.
• Stephanie Kelly, LMSW
• Beulah Kellywood, COTA/L
• Kelseaker LTD
• Lori Kelsey, ACUPUNCTURE
• Anika M Kelso, LCSW

• Speech-Language Pathologist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.