Individual provider Active NPI

Chelcey Rennee Wells

  • Speech-Language Pathologist
  • Southaven, MS
National Provider Identifier
1508168113
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S3439 Issued in MS
Practice address
7160 Tchulahoma Rd Ste B4
Southaven, MS 38671-9268
Phone
(662) 349-2733
Fax
(662) 536-1849
NPI assigned
Dec 2, 2010
Last updated
Dec 2, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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 S3439 MS Primary

Addresses

Primary practice location

7160 Tchulahoma Rd Ste B4
Southaven, MS 38671-9268

Mailing address

7160 Tchulahoma Rd Ste B4
Southaven, MS 38671-9268
Phone (662) 349-2733

Other identifiers 1

IdentifierTypeStateIssuer
S3439OtherMSSTATE LICENSE

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

LicenseStateTypeSpecialty
S3439MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Zone, LLC Speech-Language Pathologist PastSince Apr 30, 2013 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1508168113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 TCHULAHOMA RD STE B4",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719268",
            "telephone_number": "662-349-2733",
            "fax_number": "662-536-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7160 TCHULAHOMA RD STE B4",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719268",
            "telephone_number": "662-349-2733",
            "fax_number": "662-536-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CHELCEY",
        "middle_name": "RENNEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "S3439",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.