Kelly D Beckner, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004349 Issued in VA

Practice address

1215 Corporate Cir SW Ste 201
Roanoke, VA 24018-1400

Phone

(540) 312-7066

Fax

(540) 390-0195

NPI assigned

Oct 27, 2006

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Speech by Kelly

  • Speech-Language Pathologist
  • Roanoke, VA
  • NPI 1720697550
  NPD Authorized official

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1720164585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 CORPORATE CIR SW STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181400",
            "telephone_number": "540-312-7066",
            "fax_number": "540-390-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 CORPORATE CIR SW STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181400",
            "telephone_number": "540-312-7066",
            "fax_number": "540-390-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKNER",
        "first_name": "KELLY",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004978331",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7088632",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "240052",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "195182",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Elizabeth Beck, OT
• Jason Lee Beckendorf, PA-C
• Becker Clinic LTD
• Melissa Mae Beckler, OTR/L
• Dustin Beckner, CF-SLP
• Loren Beckner
• Olive Bediako, CSAC SUPERVISEE
• Angela Cool Bedwell, FNP
• Lucius Courtenay Beebe Sr., MD
• Jena Beecher, SLP

• Speech-Language Pathologist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.