Individual provider Active NPI

Carly Marie Bryant, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Clarksville, IN
National Provider Identifier
1144620915
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22006384A Issued in IN
Practice address
1329 Applegate LN
Clarksville, IN 47129-9612
Phone
(502) 633-1007
NPI assigned
Aug 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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 22006384A IN Primary

Addresses

Primary practice location

1329 Applegate LN
Clarksville, IN 47129-9612

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007

Other practice location 1

2295 Moores Rd
Seaman, OH 45679-9741
Phone (937) 386-2516 ext. 32031

Other names 1

  • Carly Voellmecke Former name

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
22006384AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1144620915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-633-1007",
            "fax_number": "502-437-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 APPLEGATE LN",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471299612",
            "telephone_number": "502-633-1007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2295 Moores Rd",
            "address_purpose": "LOCATION",
            "city": "Seaman",
            "state": "OH",
            "postal_code": "456799741",
            "country_code": "US",
            "telephone_number": "937-386-2516 x32031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "CARLY",
        "middle_name": "MARIE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006384A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "VOELLMECKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.