Individual provider Active NPI

Brenda Neulen Kiely, SLP

  • Speech-Language Pathologist
  • Martinsburg, WV
National Provider Identifier
1386357382
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-2362 Issued in WV
Practice address
2720 Charles Town Rd
Martinsburg, WV 25405-5626
Phone
(304) 263-0933
NPI assigned
Jan 4, 2023
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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 SLP-2362 WV Primary

Addresses

Primary practice location

2720 Charles Town Rd
Martinsburg, WV 25405-5626

Mailing address

655 S Willow St Ste 128
Manchester, NH 03103-5723
Phone (800) 995-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250627001556 KY Practitioner - Qualified Speech Language Pathologist 9335652965 Reassigns benefits to 1 organization
I20260618003414 VA Practitioner - Qualified Speech Language Pathologist 9335652965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13435 Cameron CT
Boston, VA 22713-4204

PO Box
821322 Attn Powerback Credentialing Dept
Philadelphia, PA 19182-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP-2362WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 4, 2025 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 4, 2025 Accepting new patients

Locations

6901 Carslaw Ct
Prospect, KY 40059
Phone (502) 480-1794

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1386357382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S WILLOW ST STE 128",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035723",
            "telephone_number": "800-995-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 CHARLES TOWN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254055626",
            "telephone_number": "304-263-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELY",
        "first_name": "BRENDA",
        "middle_name": "NEULEN",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-2362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.