Individual provider Active NPI

Kendall Marie Owen, SLP

  • Speech-Language Pathologist
  • North Canton, OH
National Provider Identifier
1508169103
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
COND-2011165 Issued in OH
Practice address
6057 Strip Ave NW
North Canton, OH 44720-9207
Phone
(330) 492-8136
NPI assigned
Dec 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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 COND-2011165 OH Primary

Addresses

Primary practice location

6057 Strip Ave NW
North Canton, OH 44720-9207

Mailing address

4515 Lindford Ave NE
Canton, OH 44705-2940
Phone (330) 933-7945

Other practice location 1

5156 Whipple Ave NW
Canton, OH 44718-2663
Phone (330) 478-1752

Other identifiers 1

IdentifierTypeStateIssuer
3055563MedicaidOH

Other names 1

  • Miss Kendall Marie Caley Former name

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
COND-2011165OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1508169103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 LINDFORD AVE NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447052940",
            "telephone_number": "330-933-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6057 STRIP AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447209207",
            "telephone_number": "330-492-8136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5156 Whipple Ave NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182663",
            "country_code": "US",
            "telephone_number": "330-478-1752",
            "fax_number": "330-478-1763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWEN",
        "first_name": "KENDALL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND-2011165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3055563",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "CALEY",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.