Kelly Spence

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3003 Issued in MS

Practice address

25112 Highway 15
Union, MS 39365-8580

Phone

(601) 774-0444

NPI assigned

Oct 17, 2008

Last updated

Oct 17, 2008By the provider in NPPES

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

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1831341148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 GARRISON RD",
            "city": "DECATUR",
            "state": "MS",
            "postal_code": "393279266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25112 HIGHWAY 15",
            "city": "UNION",
            "state": "MS",
            "postal_code": "393658580",
            "telephone_number": "601-774-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quinn's Family Pharmacy, Inc
• Rachel Farron Robertson, LCSW
• Loren Robinson, D.M.D.
• Jamaal Rogers
• SCPG Mississippi LLC (Express Rx of Union)
• Jacqueline Nechelle Steele, PT
• Union Dentistry, Inc.
• Union Discount Pharmacy
• Union Public School District
• Utown Emergency Physicians, LLC

• Speech-Language Pathologist in Union, MS
• Providers in Union, MS by specialty
• Speech-Language Pathologist in Mississippi

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