NPIMap

Organization Active NPI

Kor Speech Therapy, LLC

Doing business as Stacey Killeen

  • Speech-Language Pathologist
  • Dyer, IN
National Provider Identifier
1518476639
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22005278A Issued in IN
Legal business name
KOR SPEECH THERAPY, LLC
Doing business as
Stacey Killeen
Practice address
219 Primrose Dr.
Dyer, IN 46311
Phone
(219) 742-1400
Fax
(219) 809-2674
NPI assigned
Sep 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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

Authorized official

Name
Mrs. Stacey Lynn Killeen, M.A. CCC-SLPNPI 1841360690
Title
Speech-Language Pathologist
Phone
(219) 742-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 22005278A IN Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 146006920 IL

Addresses

Primary practice location

219 Primrose Dr.
Dyer, IN 46311

Mailing address

219 Primrose Dr.
Dyer, IN 46311
Phone (219) 742-1400

Other names 1

  • Stacey Killeen Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1518476639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 PRIMROSE DR.",
            "city": "DYER",
            "state": "IN",
            "postal_code": "46311",
            "telephone_number": "219-742-1400",
            "fax_number": "219-809-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PRIMROSE DR.",
            "city": "DYER",
            "state": "IN",
            "postal_code": "46311",
            "telephone_number": "219-742-1400",
            "fax_number": "219-809-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOR SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "KILLEEN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "219-742-1400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22005278A",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146006920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stacey Killeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.