Individual provider Active NPI

Kelsey Dethrow

  • Speech-Language Pathologist
  • Waynesville, MO
National Provider Identifier
1629523667
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2016022127 Issued in MO
Practice address
200 Fleetwood Dr
Waynesville, MO 65583-2266
Phone
(573) 842-2014
NPI assigned
Aug 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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 2016022127 MO Primary

Addresses

Primary practice location

200 Fleetwood Dr
Waynesville, MO 65583-2266

Mailing address

200 Fleetwood Dr
Waynesville, MO 65583-2266
Phone (573) 842-2014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250725003070 MO Practitioner - Qualified Speech Language Pathologist 2860909744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 1St Capitol Dr
Apt 1
Saint Charles, MO 63301-1660
Phone (636) 242-1764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC CurrentSince Jul 20, 2025 Accepting new patients
Empowerme Rehabilitation Missouri LLC Speech-Language Pathologist CurrentSince Jul 20, 2025 Accepting new patients
Empowerme Rehabilitation Missouri LLC Speech-Language Pathologist CurrentSince Jul 20, 2025 Accepting new patients
Empowerme Wellness Kansas City, LLC Speech-Language Pathologist CurrentSince Jul 20, 2025 Accepting new patients

Locations

16255 Chesterfield Pkwy W
Chesterfield, MO 63017
Phone (636) 812-6942

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1629523667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FLEETWOOD DR",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832266",
            "telephone_number": "573-842-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FLEETWOOD DR",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832266",
            "telephone_number": "573-842-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETHROW",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2016022127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.