Individual provider Active NPI

Megan Courtney Kelley, MA CCC-SLP

  • Speech-Language Pathologist
  • Lafayette, CO
National Provider Identifier
1407961691
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12065235 Issued in CO
Practice address
286 Casper Dr
Lafayette, CO 80026-9230
Phone
(720) 404-0570
Fax
(720) 208-0605
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 12065235 CO Primary

Addresses

Primary practice location

286 Casper Dr
Lafayette, CO 80026-9230

Mailing address

286 Casper Dr
Lafayette, CO 80026-9230
Phone (720) 404-0570

Other identifiers 1

IdentifierTypeStateIssuer
416-36-261MedicaidCO

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
12065235COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Speech Associates Speech-Language Pathologist Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407961691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 CASPER DR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800269230",
            "telephone_number": "720-404-0570",
            "fax_number": "720-208-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 CASPER DR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800269230",
            "telephone_number": "720-404-0570",
            "fax_number": "720-208-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MEGAN",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "12065235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416-36-261",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.