Kelly Christina Petty, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

101590 Issued in TX

Practice address

126 Genesee Ridge Drive
The Woodlands, TX 77385-3687

Phone

(210) 379-5677

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cortica ABA Therapies PA

  • Multi-Specialty Clinic/Center
  • Plano, TX
  • NPI 1942888508
  NPD (past)
• Cortica Developmental Therapies PA

  • Multi-Specialty Clinic/Center
  • Plano, TX
  • NPI 1619554680
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1750498697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 GENESEE RIDGE DRIVE",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773853687",
            "telephone_number": "210-379-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 GENESEE RIDGE DRIVE",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773853687",
            "telephone_number": "210-379-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "KELLY",
        "middle_name": "CHRISTINA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Pethe, APRN-CNP
• Samantha R. Petillon, PT, DPT
• Kimberly B Petrie, M.S. CCC-SLP
• Tracy N Petrocelli
• Haley Pettigrew, MS, LMFT, LCDC
• Tawnya Alayna Pham, OD
• Tuyet Pham, PHARM. D.
• Vicky T Pham, O.D.
• Phan DMD PLLC
• Jonathan Phan, D.M.D.

• Speech-Language Pathologist in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.