Active NPI
Kelsey Jane O'Brien, M.S., CCC-SLP
- Speech-Language Pathologist
- Clearwater, FL
National Provider Identifier
1376186163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA17475
- Practice address
- 2753 State Road 580 Ste 111
Clearwater, FL 33761-3351 - Phone
- (727) 724-5437
- Fax
- (813) 435-2125
- NPI assigned
- Oct 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA17475 | FL | Primary |
Addresses
Primary practice location
2753 State Road 580 Ste 111
Clearwater, FL 33761-3351
Mailing address
3550 Marlinspike Dr
Tampa, FL 33607-5871
Phone (815) 814-5163
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA17475 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Works, Inc. | Current | Accepting new patients |
Locations
2753 State Road 580
Ste 111
Clearwater, FL 33761
Phone (727) 724-5437
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Foundations Therapy
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Clearwater, FL
- NPI 1730389248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1376186163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3550 MARLINSPIKE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336075871",
"telephone_number": "815-814-5163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2753 STATE ROAD 580 STE 111",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337613351",
"telephone_number": "727-724-5437",
"fax_number": "813-435-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "KELSEY",
"middle_name": "JANE",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-24",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA17475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.