Kelly Fitzpatrick, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA18268 Issued in FL

Practice address

601 5TH Street South
Ste. 605
St. Petersburg, FL 33701

Phone

(727) 822-4300

Fax

(727) 456-1399

NPI assigned

Oct 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kelly McClenathan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Pediatric Gastroenterology Hepatology & Nutrition of FL P a

  • Pediatric Gastroenterology Physician
  • St Petersburg, FL
  • NPI 1780787382
  NPD

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1669800983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 58TH AVENUE NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33714",
            "telephone_number": "727-895-3702",
            "fax_number": "727-896-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH STREET SOUTH",
            "address_2": "STE. 605",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33701",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "KELLY",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-23",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP0001512",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA18268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108381500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MCCLENATHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John James Fitzgerald, OMD
• Nancy Marie Fitzgerald, D.M.D.
• Ryan Everett Fitzgerald, MD
• Stephanie Lee Fitzgerald, COTA
• Kelly Fitzpatrick, OT
• Melissa Joy Fitzpatrick, OTR/L
• Shannon Fitzpatrick, PT, DPT
• Daniel Francis Fitzsimmons, PSY.D.
• Tifani D Fivecoat, ARNP
• Richard Fixler, MA, LMHC

• Speech-Language Pathologist in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.