Kelly Marie Fawcett, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ 4023 Issued in FL

Practice address

602 Vonderburg Dr Ste 201
Brandon, FL 33511-5900

Phone

(813) 653-1149

NPI assigned

Apr 12, 2007

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

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1528282365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 DOWN PINE DR",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335843719",
            "telephone_number": "813-929-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR STE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWCETT",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ 4023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hameed R Farrokhrooz, DDS
• Keila Mabel Fatnassi, MA
• Philip John Fauerbach, LMHC
• Frederic Faugue, ARNP
• Sara Lucia Faulkner, SLP
• Sandtrail Feet, APRN
• John Edgar Fehling, MD
• Leyany Feijoo Ramos
• Kimberly Felstein
• Eric Felton, PHARMD

• Speech-Language Pathologist in Brandon, FL
• Providers in Brandon, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.