Stephanie Elisabeth Conrad Kelley, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP01113 Issued in RI

Practice address

11 King Charles Dr Ste A2
Portsmouth, RI 02871-1364

Phone

(401) 267-8757

Fax

(401) 221-4242

NPI assigned

May 7, 2014

Last updated

Aug 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Elisabeth Conrad Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Simply Speech LLC

  • Speech-Language Pathologist
  • Portsmouth, RI
  • NPI 1699376970
  NPD Authorized official

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1497165898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 NARRAGANSETT BLVD",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028715807",
            "telephone_number": "401-378-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 KING CHARLES DR STE A2",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028711364",
            "telephone_number": "401-267-8757",
            "fax_number": "401-221-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029206632",
            "country_code": "US",
            "telephone_number": "401-270-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "STEPHANIE",
        "middle_name": "ELISABETH CONRAD",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP01113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "CONRAD",
            "middle_name": "ELISABETH",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Martin Johnsen, D.M.D.
• Meghan Teresa Jordan, COTA
• Joseph D. Pianka, MD, Inc.
• Amber Kaltenstein, PSY.D.
• Julie Kaull, RD
• Ian Kelly
• Susan Mandrachia Killebrew, MSW
• Kara Elizabeth King Barron
• Kings Grant Chiropractic LLC
• Kate Sangster Knight, OT/L

• Speech-Language Pathologist in Portsmouth, RI
• Providers in Portsmouth, RI by specialty
• Speech-Language Pathologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.