Individual provider Active NPI

Ellyn Timmons

  • Speech-Language Pathologist
  • Overland Park, KS
National Provider Identifier
1427568401
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4190 Issued in KS
Practice address
6501 W 75TH St
Overland Park, KS 66204-3017
Phone
(913) 383-9866
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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 4190 KS Primary

Addresses

Primary practice location

6501 W 75TH St
Overland Park, KS 66204-3017

Mailing address

1111 W 46TH St Apt 39
Kansas City, MO 64112-1214
Phone (217) 620-8517

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
4190KSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1427568401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W 46TH ST APT 39",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121214",
            "telephone_number": "217-620-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 W 75TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662043017",
            "telephone_number": "913-383-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "ELLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "4190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.