Kelsey Bothwell

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

109046 Issued in IA

Practice address

925 Denver St
Waterloo, IA 50702-3620

Phone

(719) 684-6629

NPI assigned

Jul 24, 2024

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cedar Valley Speech and Language, LLC

  • Speech-Language Pathologist
  • Waterloo, IA
  • NPI 1982432605
  NPD Authorized official

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1568290286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 DENVER ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507023620",
            "telephone_number": "719-684-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 DENVER ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507023620",
            "telephone_number": "719-684-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHWELL",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "109046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Rae Borcherding, ARNP
• Ryan Norman Borgwardt, D.D.S.
• Teresa Boring
• Amy Bork, MS, RD, CD
• Kimberlee Kay Borneman, C.N.M.
• Rhonda Bottke, ARNP
• Cara Beth Boubin, CADC
• Brian Lee Bouck, DDS
• Mary Kathryn Bowen, M.D.
• Kathi K Bower, ARNP

• Speech-Language Pathologist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Speech-Language Pathologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.