Individual provider Active NPI

Kelly Peters

  • Speech-Language Pathologist
  • Salem, NH
National Provider Identifier
1295045672
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL009739 Issued in PA
Practice address
2 Keewaydin Dr
Salem, NH 03079-2839
Phone
(800) 995-2673
Fax
(866) 420-1055
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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 SL009739 PA Primary

Addresses

Primary practice location

2 Keewaydin Dr
Salem, NH 03079-2839

Mailing address

2 Keewaydin Dr
Salem, NH 03079-2839
Phone (800) 995-2673

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
SL009739PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1295045672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 KEEWAYDIN DR",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792839",
            "telephone_number": "800-995-2673",
            "fax_number": "866-420-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 KEEWAYDIN DR",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792839",
            "telephone_number": "800-995-2673",
            "fax_number": "866-420-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.