Active NPI
Kelsey Anne Blake, SLP
- Speech-Language Pathologist
- Waldorf, MD
National Provider Identifier
1144908187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 11350 Pembrooke SQ
Waldorf, MD 20603-4809 - Phone
- (301) 885-0033
- NPI assigned
- Jul 10, 2023
- Sex
- Female
- Sole proprietor
- No
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 | MD | Primary |
Addresses
Primary practice location
11350 Pembrooke SQ
Waldorf, MD 20603-4809
Mailing address
25727 Jones Wharf Rd
Hollywood, MD 20636-2436
Phone (435) 262-7166
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Refined Speech Solutions, LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Hearing and Speech Clinic/Center
- Hollywood, MD
- NPI 1952137598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1144908187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25727 JONES WHARF RD",
"city": "HOLLYWOOD",
"state": "MD",
"postal_code": "206362436",
"telephone_number": "435-262-7166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11350 PEMBROOKE SQ",
"city": "WALDORF",
"state": "MD",
"postal_code": "206034809",
"telephone_number": "301-885-0033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "KELSEY",
"middle_name": "ANNE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.