Kelli Gibbons, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

19460 Issued in TX

Practice address

2203 Babcock Rd
San Antonio, TX 78229-4412

Phone

(210) 614-3911

Fax

(210) 616-0443

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

No

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 Science

State licenses

Practice roles

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.

• From the Heart Pediatric Therapy Inc

  • Home Health Agency
  • San Antonio, TX
  • NPI 1356770713
  NPD (past) Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1265566251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15222 ELM PARK ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782472902",
            "telephone_number": "210-326-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 BABCOCK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294412",
            "telephone_number": "210-614-3911",
            "fax_number": "210-616-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "KELLI",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "19460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Gibbens
• Victoria Lynne Gibbens
• Jennifer Gibbon
• Casey James Gibbons, CCC-SLP
• Karen L. Gibbons, MD
• Steven David Gibbons, MD
• Tiffaney Michelle Gibbons, LPC
• Alexandria Gibbs, DDS
• Kenda Marie Gibbs
• Kimberly Bailey Gibbs, M.D.

• Speech-Language Pathologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.