Individual provider Active NPI

Kadie Brianne Sellers, ST

  • Speech-Language Pathologist
  • Conroe, TX
National Provider Identifier
1215774740
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
118822 Issued in TX
Practice address
4714 FM 1488 Rd Ste 204
Conroe, TX 77384-4930
Phone
(936) 224-7940
Fax
(281) 789-4499
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 118822 TX Primary

Addresses

Primary practice location

4714 FM 1488 Rd Ste 204
Conroe, TX 77384-4930

Mailing address

4714 FM 1488 Rd Ste 204
Conroe, TX 77384-4930
Phone (936) 224-7940

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
118822TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Speech Spot, LLC Single Specialty CurrentSince Jul 21, 2024 Accepting new patients

Locations

4714 FM 1488 Rd
Ste 204
Conroe, TX 77384
Phone (281) 259-5552

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.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1215774740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 FM 1488 RD STE 204",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844930",
            "telephone_number": "936-224-7940",
            "fax_number": "281-789-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4714 FM 1488 RD STE 204",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773844930",
            "telephone_number": "936-224-7940",
            "fax_number": "281-789-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "KADIE",
        "middle_name": "BRIANNE",
        "name_prefix": "Ms.",
        "credential": "ST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.