Kellie P Watson, MSP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3812 Issued in SC

Practice address

420 Pat Rd
Lexington, SC 29073-8435

Phone

(803) 767-5153

Fax

(803) 955-0972

NPI assigned

May 21, 2007

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

Other identifiers 2

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.

• Speech Connections LLC

  • Speech-Language Assistant
  • Lexington, SC
  • NPI 1225117666

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750590378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 OLD 96 INDIAN TRL",
            "city": "BATESBURG",
            "state": "SC",
            "postal_code": "290069602",
            "telephone_number": "803-685-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PAT RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290738435",
            "telephone_number": "803-767-5153",
            "fax_number": "803-955-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KELLIE",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "MSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL LICENSE",
            "identifier": "12028242",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3812",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Washington
• Jennifer Waterman
• Aleah Waters, PTA
• Samantha Jo Waters, LPC
• Ann Marie Watson
• Nancy Watson, RN,BSN
• Nicholas Garrett Watson, M.D.
• Erika Watts, MSR, OTR/L
• Catherine Collins Wayland, FNP
• Kelly Jean Weaver, MED, EDS, LPC

• Speech-Language Pathologist in Lexington, SC
• Providers in Lexington, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.