Individual provider Active NPI

Kelsey Williams

  • Speech-Language Pathologist
  • Peyton, CO
National Provider Identifier
1265197073
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP.0004601 Issued in CO
Practice address
13039 Falcon Hwy
Peyton, CO 80831-8024
Phone
(719) 209-3365
Fax
(719) 960-2139
NPI assigned
Nov 5, 2021
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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 SLP.0004601 CO Primary

Addresses

Primary practice location

13039 Falcon Hwy
Peyton, CO 80831-8024

Mailing address

13039 Falcon Hwy
Peyton, CO 80831-8024
Phone (719) 209-3365

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211110001044 CO Practitioner - Qualified Speech Language Pathologist 9931598182 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chuckies Place Occupational Therapist CurrentSince Oct 1, 2021 Accepting new patients
Chuckies Place CurrentSince Oct 1, 2021 Accepting new patients

Locations

13039 Falcon Hwy
Peyton, CO 80831
Phone (719) 209-3365

Organizations & group practices 2

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": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1265197073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13039 FALCON HWY",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318024",
            "telephone_number": "719-209-3365",
            "fax_number": "719-960-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13039 FALCON HWY",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318024",
            "telephone_number": "719-209-3365",
            "fax_number": "719-960-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0004601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peyton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.