Individual provider Active NPI

Kelsie Noelle Maynes

  • Speech-Language Pathologist
  • Anchorage, AK
National Provider Identifier
1821716945
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
198853 Issued in AK
Practice address
235 E 9TH Ave
Anchorage, AK 99501-7501
Phone
(907) 334-9001
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 198853 AK Primary

Addresses

Primary practice location

235 E 9TH Ave
Anchorage, AK 99501-7501

Mailing address

3331 Amber Bay Loop
Anchorage, AK 99515-2310
Phone (715) 331-9368

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
198853AKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1821716945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 AMBER BAY LOOP",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995152310",
            "telephone_number": "715-331-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E 9TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995017501",
            "telephone_number": "907-334-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNES",
        "first_name": "KELSIE",
        "middle_name": "NOELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "198853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.