Individual provider Active NPI

Nicole Lyn Kenney, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Aurora, CO
National Provider Identifier
1699327585
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
15701 E 1St Ave Ste 106
Aurora, CO 80011-9037
Phone
(303) 344-8060
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

15701 E 1St Ave Ste 106
Aurora, CO 80011-9037

Mailing address

15701 E 1St Ave Ste 106
Aurora, CO 80011-9037

Other practice location 1

6795 S Albion St
Centennial, CO 80122-2101
Phone (585) 469-0007

Other identifiers 1

IdentifierTypeStateIssuer
14173756OtherASHA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240524003253 CO Practitioner - Qualified Speech Language Pathologist 3577905215 Reassigns benefits to 1 organization
I20240527000026 NY Practitioner - Qualified Speech Language Pathologist 3577905215 Reassigns benefits to 1 organization
I20240531001995 CA Practitioner - Qualified Speech Language Pathologist 3577905215 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
37103CAMDDentist
034164NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince Jul 15, 2024 Accepting new patients
Nicolekenney,LLC CurrentSince Jan 24, 2021 Accepting new patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Jul 15, 2024 Accepting new patients

Locations

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

102 S Tejon St
Colorado Springs, CO 80903
Phone (719) 257-2101

102 S Tejon St
Ste 1100
Colorado Springs, CO 80903
Phone (514) 851-3224

99 Hudson St
Fl 5
New York, NY 10013
Phone (646) 301-2578

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

7600 Chevy Chase Dr
Austin, TX 78752
Phone (512) 649-3880

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1699327585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15701 E 1ST AVE STE 106",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 E 1ST AVE STE 106",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119037",
            "telephone_number": "303-344-8060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6795 S Albion St",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801222101",
            "country_code": "US",
            "telephone_number": "585-469-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "NICOLE",
        "middle_name": "LYN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14173756",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.

Verify at the official NPI Registry.