Individual provider Active NPI

Kelly Sue Waryas, M.A. - CCC

  • Speech-Language Pathologist
  • Howell, MI
National Provider Identifier
1427309129
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12092290 Issued in MI
Practice address
555 Bareback TRL
Howell, MI 48855-8286
Phone
(517) 518-2270
NPI assigned
Sep 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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 12092290 MI Primary

Addresses

Primary practice location

555 Bareback TRL
Howell, MI 48855-8286

Mailing address

555 Bareback TRL
Howell, MI 48855-8286
Phone (517) 518-2270

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
12092290MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1427309129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BAREBACK TRL",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488558286",
            "telephone_number": "517-518-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BAREBACK TRL",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488558286",
            "telephone_number": "517-518-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARYAS",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "M.A. - CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12092290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.