Kellie Vaughan Remington

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-12989 Issued in OH

Practice address

3650 Grafton Rd
Brunswick, OH 44212-1804

Phone

(330) 273-0485

NPI assigned

May 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1487181764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 GRAFTON RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442121804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 GRAFTON RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442121804",
            "telephone_number": "330-273-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMINGTON",
        "first_name": "KELLIE",
        "middle_name": "VAUGHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "2017227-SP",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-12989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1564187",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Brunswick, OH
• Providers in Brunswick, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.