Individual provider Active NPI

Kelly Moll

  • Speech-Language Pathologist
  • West Palm Beach, FL
National Provider Identifier
1730517814
Registry record updated Dec 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ6485 Issued in FL
Practice address
5589 Okeechobee Blvd
Suite 205
West Palm Beach, FL 33417-4486
Phone
(260) 409-9201
NPI assigned
Oct 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2013

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 SZ6485 FL Primary

Addresses

Primary practice location

5589 Okeechobee Blvd
Suite 205
West Palm Beach, FL 33417-4486

Mailing address

5589 Okeechobee Blvd
Suite 205
West Palm Beach, FL 33417-4486

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

State licenses

LicenseStateTypeSpecialty
SZ6485FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386460800000",
    "number": "1730517814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5589 OKEECHOBEE BLVD",
            "address_2": "SUITE 205",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5589 OKEECHOBEE BLVD",
            "address_2": "SUITE 205",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174486",
            "telephone_number": "260-409-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLL",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-28",
        "last_updated": "2013-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ6485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.

Verify at the official NPI Registry.