Kelly Cooper, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9027 Issued in MN

Legal business name

KELLY COOPER, LLC

Practice address

1300 W Medicine Lake Dr
#321
Plymouth, MN 55441-4859

Phone

(320) 293-7827

NPI assigned

Dec 18, 2013

Last updated

Dec 18, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Cooper, M.S. CCC-SLP

Title

Speech Language Pathologist

Phone

(320) 293-7827

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1538580436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W MEDICINE LAKE DR",
            "address_2": "#321",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W MEDICINE LAKE DR",
            "address_2": "#321",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554414859",
            "telephone_number": "320-293-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY COOPER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "320-293-7827",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.