Active NPI
Katelyn Roelle, CCC-SLP
- Speech-Language Pathologist
- Peetz, CO
National Provider Identifier
1558038984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 201857
- Practice address
- 311 Coleman Ave
Peetz, CO 80747-5000 - Phone
- (970) 334-2361
- NPI assigned
- Aug 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 201857 | CO | Primary |
Addresses
Primary practice location
311 Coleman Ave
Peetz, CO 80747-5000
Mailing address
301 W Powell St
Haxtun, CO 80731-2654
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201857 | CO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Boces | Past | 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 and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Haxtun, CO
- NPI 1942714753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1558038984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 W POWELL ST",
"city": "HAXTUN",
"state": "CO",
"postal_code": "807312654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 COLEMAN AVE",
"city": "PEETZ",
"state": "CO",
"postal_code": "807475000",
"telephone_number": "970-334-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROELLE",
"first_name": "KATELYN",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-24",
"last_updated": "2021-08-24",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "201857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.