Active NPI
Kai Jerrell, M.A. CCC-SLP
- Speech-Language Pathologist
- Charlotte, NC
National Provider Identifier
1699073197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5842
- Practice address
- 3116 Milton Rd Ste F
Charlotte, NC 28215-5079 - Phone
- (980) 237-6226
- NPI assigned
- Mar 8, 2011
- Last updated
- Nov 8, 2018
- 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 | 5842 | NC | Primary |
Addresses
Primary practice location
3116 Milton Rd Ste F
Charlotte, NC 28215-5079
Mailing address
3116 Milton Rd Ste F
Charlotte, NC 28215-5079
Phone (980) 237-6226
Other practice location 1
7900 Matthews Mint Hill Rd
Mint Hill, NC 28227-6562
Phone (980) 237-6226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7411868 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5842 | NC | MD | Speech-Language Pathologist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1699073197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3116 MILTON RD STE F",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282155079",
"telephone_number": "980-237-6226",
"fax_number": "980-237-6288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3116 MILTON RD STE F",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282155079",
"telephone_number": "980-237-6226"
}
],
"practiceLocations": [
{
"address_1": "7900 Matthews Mint Hill Rd",
"address_purpose": "LOCATION",
"city": "Mint Hill",
"state": "NC",
"postal_code": "282276562",
"country_code": "US",
"telephone_number": "980-237-6226",
"fax_number": "980-237-6288",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JERRELL",
"first_name": "KAI",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-08",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "5842",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7411868",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.