Individual provider Active NPI

Debra Kelly, SLP

  • Speech-Language Pathologist
  • Louisville, NE
National Provider Identifier
1346627403
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2014006805 Issued in NE
Practice address
202 W 3Rd St
Louisville, NE 68037-7089
Phone
(402) 234-4215
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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 2014006805 NE Primary

Addresses

Primary practice location

202 W 3Rd St
Louisville, NE 68037-7089

Mailing address

202 W 3Rd St
Louisville, NE 68037-7089
Phone (402) 234-4215

Other identifiers 1

IdentifierTypeStateIssuer
2014006805OtherNENEBRASKA DEPARTMENT OF EDUCATION

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
2014006805NEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1346627403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W 3RD ST",
            "city": "LOUISVILLE",
            "state": "NE",
            "postal_code": "680377089",
            "telephone_number": "402-234-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W 3RD ST",
            "city": "LOUISVILLE",
            "state": "NE",
            "postal_code": "680377089",
            "telephone_number": "402-234-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DEBRA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2014006805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA DEPARTMENT OF EDUCATION",
            "identifier": "2014006805",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.