Active NPI
Carol Marie Ellis, PHD, CCC-SLP
- Speech-Language Pathologist
- Hays, KS
National Provider Identifier
1669893822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3569
- Practice address
- 600 Park St
Hays, KS 67601-4009 - Phone
- (785) 628-5366
- NPI assigned
- Dec 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3569 | KS | Primary |
Addresses
Primary practice location
600 Park St
Hays, KS 67601-4009
Mailing address
115 W 34TH St
Hays, KS 67601-1628
Phone (785) 628-5366
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3569 | KS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Hays State University | 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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Hays, KS
- NPI 1609080001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1669893822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 W 34TH ST",
"city": "HAYS",
"state": "KS",
"postal_code": "676011628",
"telephone_number": "785-628-5366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 PARK ST",
"city": "HAYS",
"state": "KS",
"postal_code": "676014009",
"telephone_number": "785-628-5366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "CAROL",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHD, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-13",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "3569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hays, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.