Active NPI
Kelley Shirley, SLP
- Speech-Language Pathologist
- Birmingham, AL
National Provider Identifier
1235258674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6288548
- Practice address
- 4778 Overton Rd
Birmingham, AL 35210-3803 - Phone
- (205) 957-0294
- Fax
- (205) 957-0298
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 6288548 | AL | Primary |
Addresses
Primary practice location
4778 Overton Rd
Birmingham, AL 35210-3803
Mailing address
4778 Overton Rd
Birmingham, AL 35210-3803
Phone (205) 957-0294
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 515-35381 | Other | AL | BCBS PROVIDER NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6288548 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitchell'S Place, Inc. | Speech-Language Pathologist | Past | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235258674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4778 OVERTON RD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352103803",
"telephone_number": "205-957-0294",
"fax_number": "205-957-0298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4778 OVERTON RD",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352103803",
"telephone_number": "205-957-0294",
"fax_number": "205-957-0298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "KELLEY",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "6288548",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "515-35381",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.