Individual provider Active NPI

Kelli Virginia Kemp, SLP

  • Speech-Language Pathologist
  • Granbury, TX
National Provider Identifier
1770125254
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
115606 Issued in NU
Practice address
600 Reunion CT
Granbury, TX 76048-1610
Phone
(817) 573-3773
NPI assigned
Oct 16, 2019
Last updated
Oct 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 115606 TN
Speech-Language Pathologist 235Z00000X 115606 NU Primary

Addresses

Primary practice location

600 Reunion CT
Granbury, TX 76048-1610

Mailing address

600 Reunion CT
Granbury, TX 76048-1610

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
115606TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1770125254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 REUNION CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 REUNION CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481610",
            "telephone_number": "817-573-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "KELLI",
        "middle_name": "VIRGINIA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "115606",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": "115606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.