Active NPI
Kaelan Mylo Henman, SLP
- Speech-Language Pathologist
- Bellefontaine, OH
National Provider Identifier
1649813130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.13402
- Practice address
- 204 Greenridge Dr
Bellefontaine, OH 43311-2750 - Phone
- (419) 270-4796
- NPI assigned
- Oct 28, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101005768 | ||
| Speech-Language Pathologist | 235Z00000X | SP.13402 | OH | Primary |
Addresses
Primary practice location
204 Greenridge Dr
Bellefontaine, OH 43311-2750
Mailing address
204 Greenridge Dr
Bellefontaine, OH 43311-2750
Phone (419) 270-4796
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7101005768 | Other | MI | LICENSE |
| SP.13402 | Other | OH | LICENSE |
Other names 1
- Kaylee Michaele Henman
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP.13402 | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Northern PT, LLC | 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 and National Provider Directory roles.
-
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- Sparta, MI
- NPI 1972592525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747008000000",
"number": "1649813130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 GREENRIDGE DR",
"city": "BELLEFONTAINE",
"state": "OH",
"postal_code": "433112750",
"telephone_number": "419-270-4796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 GREENRIDGE DR",
"city": "BELLEFONTAINE",
"state": "OH",
"postal_code": "433112750",
"telephone_number": "419-270-4796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENMAN",
"first_name": "KAELAN",
"middle_name": "MYLO",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-28",
"last_updated": "2025-05-12",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": "7101005768",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.13402",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "7101005768",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "SP.13402",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KAYLEE",
"last_name": "HENMAN",
"middle_name": "MICHAELE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bellefontaine, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.