Individual provider Active NPI

Kelly Benton Tynch, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Fletcher, NC
National Provider Identifier
1295970473
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4217 Issued in NC
Practice address
4020 Hendersonville Rd Ste B
Fletcher, NC 28732-8251
Phone
(828) 687-8428
NPI assigned
Dec 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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 4217 NC Primary

Addresses

Primary practice location

4020 Hendersonville Rd Ste B
Fletcher, NC 28732-8251

Mailing address

560 Maple St
Brevard, NC 28712-3881
Phone (828) 884-3364

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4217NCMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1295970473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MAPLE ST",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287123881",
            "telephone_number": "828-884-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 HENDERSONVILLE RD STE B",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287328251",
            "telephone_number": "828-687-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNCH",
        "first_name": "KELLY",
        "middle_name": "BENTON",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fletcher, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.