Individual provider Active NPI

Kelly Garcia

  • Speech-Language Pathologist
  • Monroe, NJ
National Provider Identifier
1750020004
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS01082100 Issued in NJ
Practice address
104 Interchange PLZ Ste 103
Monroe, NJ 08831-2038
Phone
(973) 849-7521
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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 41YS01082100 NJ Primary

Addresses

Primary practice location

104 Interchange PLZ Ste 103
Monroe, NJ 08831-2038

Mailing address

27 Lamont Ave Apt 10
Hamilton, NJ 08619-2735

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://app.clinicsource.com/ClinicPortal/login.aspx?ReturnUrl=%2fClinicPortal%2fNewScheduler.aspx Health Information Exchange (HIE)

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
41YS01082100NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1750020004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 LAMONT AVE APT 10",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086192735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 INTERCHANGE PLZ STE 103",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088312038",
            "telephone_number": "973-849-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS01082100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://app.clinicsource.com/ClinicPortal/login.aspx?ReturnUrl=%2fClinicPortal%2fNewScheduler.aspx",
            "affiliation": "N",
            "endpointDescription": "Clinic Source",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "104 Interchange Plz Ste 103",
            "city": "Monroe",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "088312038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.