Active NPI
Kelly Bryant
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1578858437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP14204
- Practice address
- 2115 Beverly Blvd
Los Angeles, CA 90057-2203 - Phone
- (323) 938-3434
- NPI assigned
- Jun 17, 2011
- 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 | SP14204 | CA | Primary |
Addresses
Primary practice location
2115 Beverly Blvd
Los Angeles, CA 90057-2203
Mailing address
2115 Beverly Blvd
Los Angeles, CA 90057-2203
Phone (323) 938-3434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP14204 | Other | CA | CALIFORNIA LICENSE |
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 |
|---|---|---|---|
| SP14204 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holding Hands, Inc. | Past | Accepting new patients | |
| Holding Hands Opco LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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- Burbank, CA
- NPI 1467761940
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- Developmentally Disabled Services Day Training Agency
- Burbank, CA
- NPI 1568771046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308268800000",
"number": "1578858437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 BEVERLY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572203",
"telephone_number": "323-938-3434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 BEVERLY BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572203",
"telephone_number": "323-938-3434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-17",
"last_updated": "2011-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP14204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA LICENSE",
"identifier": "SP14204",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.