Kelly Nielsen, ST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP5894 Issued in AZ

Practice address

1255 N Arizona Ave Unit 1217
Chandler, AZ 85225-0710

Phone

(602) 666-6620

Fax

(602) 666-6074

NPI assigned

Aug 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Simers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Capptcg, LLC

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1922498500

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1639900798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13835 N TATUM BLVD STE 9442",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325581",
            "telephone_number": "602-380-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N ARIZONA AVE UNIT 1217",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852250710",
            "telephone_number": "602-666-6620",
            "fax_number": "602-666-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "KELLY",
        "credential": "ST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP5894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SIMERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicola Nichols
• Patricia Lee Nichols, NURSE PRACTITIONER
• Matthew Ryan Nickerson, P.T. DPT
• Kim Janette Nicoletti, PT
• Donald C Nielsen
• Hailey Nielson
• Peter A Nielson, PHARMD
• Spencer Luna Nui Niemann, D.P.M.
• Alison Renae Niesen, LMSW
• Susanne Elizabeth Nigro

• Speech-Language Pathologist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.