NPIMap

Individual provider Active NPI

Kelly Annino, SLP

  • Speech-Language Pathologist
  • Oakville, CT
National Provider Identifier
1619207685
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
003902 Issued in CT
Practice address
900 Main St
Oakville, CT 06779-1999
Phone
(860) 945-3012
Fax
(860) 945-9854
NPI assigned
Jan 13, 2010
Last updated
Jan 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 003902 CT Primary

Addresses

Primary practice location

900 Main St
Oakville, CT 06779-1999

Mailing address

PO Box 425
Watertown, CT 06795-0425
Phone (860) 945-3012

Other names 1

  • Kelly Ryder Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Unlimited-Children's Therapy Center Speech-Language Pathologist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1619207685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067950425",
            "telephone_number": "860-945-3012",
            "fax_number": "860-945-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST",
            "city": "OAKVILLE",
            "state": "CT",
            "postal_code": "067791999",
            "telephone_number": "860-945-3012",
            "fax_number": "860-945-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNINO",
        "first_name": "KELLY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "RYDER",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oakville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.