Active NPI
Kelly Sellers
- Speech-Language Pathologist
- Canton, MS
National Provider Identifier
1144675299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3434
- Practice address
- 1421 E Peace St
Canton, MS 39046-4938 - Phone
- (601) 855-2560
- NPI assigned
- Apr 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 3434 | MS | Primary |
Addresses
Primary practice location
1421 E Peace St
Canton, MS 39046-4938
Mailing address
4109 Highway 98 W
Summit, MS 39666-9132
Phone (601) 276-3900
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3434 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461628800000",
"number": "1144675299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4109 HIGHWAY 98 W",
"city": "SUMMIT",
"state": "MS",
"postal_code": "396669132",
"telephone_number": "601-276-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 E PEACE ST",
"city": "CANTON",
"state": "MS",
"postal_code": "390464938",
"telephone_number": "601-855-2560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-26",
"last_updated": "2016-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "3434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.