Kelsey Elizabeth Smith

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

528486 Issued in MN

Practice address

2101 Wooddale Dr Ste a
Woodbury, MN 55125-2933

Phone

(651) 738-9888

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1710601679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252933",
            "telephone_number": "651-738-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252933",
            "telephone_number": "651-738-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "S530-5059-8690-02",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ksmith1@familyachievement.com",
            "affiliation": "N",
            "endpointDescription": "Work Email Address",
            "address_1": "2101 Wooddale Dr Ste A",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551252933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David James Smith, D.C.
• Diana Climaco Smith, M.D.
• Emma Katherine Smith
• Jana Marie Smith, CCC/SLP
• Kathleen Smith, PHARMD
• Lauren Lee Smith
• Laurie Anne Smith, DO
• Madison Smith
• Mark Edward Smith, D.O.
• Michaela D.M. Smith, PSYD, LP

• Speech-Language Pathologist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.