Individual provider Active NPI

Kelsey Lee, M.A, CCC-SLP

  • Speech-Language Pathologist
  • Cape Girardeau, MO
National Provider Identifier
1114475936
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2016032961 Issued in MO
Practice address
1910 Whitener St
Cape Girardeau, MO 63701-5239
Phone
(573) 339-1201
NPI assigned
Sep 21, 2016
Last updated
Jan 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2016032961 MO Primary

Addresses

Primary practice location

1910 Whitener St
Cape Girardeau, MO 63701-5239

Mailing address

115 Helen Ave
Chaffee, MO 63740-1112
Phone (573) 318-0139

Other practice location 1

801 S State Highway 53
Campbell, MO 63933-1367
Phone (573) 246-2133 ext. 62133

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2016032961MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1114475936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HELEN AVE",
            "city": "CHAFFEE",
            "state": "MO",
            "postal_code": "637401112",
            "telephone_number": "573-318-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 WHITENER ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015239",
            "telephone_number": "573-339-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S State Highway 53",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "MO",
            "postal_code": "639331367",
            "country_code": "US",
            "telephone_number": "573-246-2133 x62133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KELSEY",
        "name_prefix": "Mrs.",
        "credential": "M.A, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2016032961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.