Individual provider Active NPI

Kelsey Sestak

  • Speech-Language Pathologist
  • Wahoo, NE
National Provider Identifier
1174979322
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2015009081 Issued in NE
Practice address
2201 N Locust St
Wahoo, NE 68066-1093
Phone
(402) 443-3101
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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 2015009081 NE Primary

Addresses

Primary practice location

2201 N Locust St
Wahoo, NE 68066-1093

Mailing address

2201 N Locust St
Wahoo, NE 68066-1093
Phone (402) 443-3101

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

LicenseStateTypeSpecialty
2015009081NEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1174979322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 N LOCUST ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680661093",
            "telephone_number": "402-443-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N LOCUST ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680661093",
            "telephone_number": "402-443-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESTAK",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2015009081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahoo, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.

Verify at the official NPI Registry.