Kelley Weusthoff

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2016010577 Issued in MO

Practice address

4290 Gravois Rd
House Springs, MO 63051-2301

Phone

(636) 677-3473

NPI assigned

Jun 15, 2016

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

State licenses

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1275983751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 GRAVOIS RD",
            "city": "HOUSE SPRINGS",
            "state": "MO",
            "postal_code": "630512301",
            "telephone_number": "636-677-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 GRAVOIS RD",
            "city": "HOUSE SPRINGS",
            "state": "MO",
            "postal_code": "630512301",
            "telephone_number": "636-677-3473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12110 Clayton Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312516",
            "country_code": "US",
            "telephone_number": "314-989-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEUSTHOFF",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2022-08-01",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2016010577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Vessell, LCSW
• Morgan Leigh Von Seelen, OTR/L, MOT
• Zachary Voss
• Debra Sue Weaver
• Ashley Lauren Wegener
• Renee L Willer, APRN
• Linda Rene Winterberger, DO
• Deann Jenifer Yount, LCSW

• Speech-Language Pathologist in House Springs, MO
• Providers in House Springs, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.