Kellan Mallory Wood

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

211 Windwood Drive
Bluefield, VA 24605

Phone

(304) 887-5357

NPI assigned

Aug 7, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kellan Nicole Mallory Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Just Speechy LLC

  • Speech-Language Pathologist
  • Princeton, WV
  • NPI 1003783929
  NPD Authorized official
• Linguacare Associates

  • Hearing and Speech Clinic/Center
  • Daniels, WV
  • NPI 1952650343
  NPD (past)

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1437769189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 WINDWOOD DRIVE",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "24605",
            "telephone_number": "304-887-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 WINDWOOD DRIVE",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "24605",
            "telephone_number": "304-887-5357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2012 Whiteoak Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "WV",
            "postal_code": "247129676",
            "country_code": "US",
            "telephone_number": "304-887-5357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KELLAN",
        "middle_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2024-11-04",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLAN",
            "last_name": "MALLORY",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Westwood Medical Park Operations LLC
• Danise Conley White, OTRL
• Jodie Faith Whitlock
• Jeffrey Alan Williams, D.C.
• Jennifer Lee Williams, LPTA
• Jonathan David Yates, D.O

• Speech-Language Pathologist in Bluefield, VA
• Providers in Bluefield, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.