Active NPI
Kelly Souza
- Speech-Language Pathologist
- Independence, MO
National Provider Identifier
1730567041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2014020540
- Practice address
- 18000 E Kentucky Rd
Independence, MO 64058-1115 - Phone
- (816) 650-7400
- NPI assigned
- May 7, 2015
- Last updated
- Jan 25, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 2014020540 | MO | Primary |
Addresses
Primary practice location
18000 E Kentucky Rd
Independence, MO 64058-1115
Mailing address
2101 N Twyman Rd
Independence, MO 64058-3200
Phone (816) 650-7400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2014020540 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1730567041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 N TWYMAN RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640583200",
"telephone_number": "816-650-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18000 E KENTUCKY RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640581115",
"telephone_number": "816-650-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-07",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2014020540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.