Individual provider Active NPI

Daniel Kelly, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Plymouth Meeting, PA
National Provider Identifier
1467749572
Registry record updated Jul 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL008724 Issued in PA
Practice address
2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Phone
(610) 834-1122
NPI assigned
Jul 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2011

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 SL008724 PA Primary

Addresses

Primary practice location

2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047

Mailing address

226 Garden View Dr
Thorndale, PA 19372-1156

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
SL008724PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310256000000",
    "number": "1467749572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 GARDEN VIEW DR",
            "city": "THORNDALE",
            "state": "PA",
            "postal_code": "193721156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD",
            "address_2": "SUITE 240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047",
            "telephone_number": "610-834-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DANIEL",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-10",
        "last_updated": "2011-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL008724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2011; 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.