Individual provider Active NPI

Kelley Ann Colyott, CCC-SLP

  • Speech-Language Pathologist
  • Riverdale, GA
National Provider Identifier
1154669216
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007118 Issued in GA
Practice address
315 Upper Riverdale Rd SW
Riverdale, GA 30274-2500
Phone
(770) 991-2636
NPI assigned
Jan 24, 2013
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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 SLP007118 GA Primary

Addresses

Primary practice location

315 Upper Riverdale Rd SW
Riverdale, GA 30274-2500

Mailing address

315 Upper Riverdale Rd SW
Riverdale, GA 30274-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918004218 GA Practitioner - Qualified Speech Language Pathologist 7618331067 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP007118GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Ga, LLC Speech-Language Pathologist CurrentSince Oct 1, 2023 Accepting new patients
Select Rehabilitation, LLC Speech-Language Pathologist CurrentSince Apr 1, 2024 Accepting new patients
The Weston Group Inc. CurrentSince Aug 21, 2023 Accepting new patients
The Weston Group Inc. Speech-Language Pathologist CurrentSince Aug 21, 2023 Accepting new patients
Select Outpatient Services Inc PastSince Jan 1, 2017 Accepting new patients

Locations

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1154669216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742500",
            "telephone_number": "770-991-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLYOTT",
        "first_name": "KELLEY",
        "middle_name": "ANN",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.