Kelly A Peters, MA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

220004869A Issued in IN

Practice address

1579 E 85TH Ave
Merrillville, IN 46410-8901

Phone

(219) 525-4973

NPI assigned

Aug 6, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Bridges of Possibilities, LLC

  • Occupational Therapist
  • Merrillville, IN
  • NPI 1134570054
  NPD

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1174754261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11517 HANLEY ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078731",
            "telephone_number": "219-405-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 E 85TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108901",
            "telephone_number": "219-525-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "220004869A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kismet Perkins
• Jasmine Perry
• Personal Wellness Medical Addiction Services
• Personal Wellness Medical LLC
• Amanda D Peters
• Michelle M Peters, MSW, LCSW
• Lauren Kay Peterson, LCSW
• Nicole Peterson
• Marija Petkoska Gjorgioska
• Catherine Petrak

• Speech-Language Pathologist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.