Active NPI
Gloria R. Kelly, SLP,TSHH,MA-CCC-SLP
- Speech-Language Pathologist
- Buffalo, NY
National Provider Identifier
1457670994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 003384-1
- Practice address
- 106 Appenheimer Ave
Buffalo, NY 14214-2918 - Phone
- (716) 873-3901
- Fax
- (716) 897-8093
- NPI assigned
- May 24, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 003384-1 | NY | Primary |
Addresses
Primary practice location
106 Appenheimer Ave
Buffalo, NY 14214-2918
Mailing address
106 Appenheimer Ave
Buffalo, NY 14214-2918
Phone (716) 873-3901
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003384-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274659200000",
"number": "1457670994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 APPENHEIMER AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142142918",
"telephone_number": "716-873-3901",
"fax_number": "716-897-8093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 APPENHEIMER AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142142918",
"telephone_number": "716-873-3901",
"fax_number": "716-897-8093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "GLORIA",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "SLP,TSHH,MA-CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-24",
"last_updated": "2010-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "003384-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.