Active NPI
Ronald W Kelley, SLP
- Speech-Language Pathologist
- Kalamazoo, MI
National Provider Identifier
1841424967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 00107383
- Practice address
- 1000 Oakland Dr FL 3
Kalamazoo, MI 49008-1282 - Phone
- (269) 387-7004
- Fax
- (269) 387-7026
- NPI assigned
- May 4, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 00107383 | MI | Primary |
Addresses
Primary practice location
1000 Oakland Dr FL 3
Kalamazoo, MI 49008-1282
Mailing address
1000 Oakland Dr FL 3
Kalamazoo, MI 49008-1282
Phone (269) 387-7004
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46-31868 | Other | UNITED HEALTHCARE INSURANCE | |
| 40-4702665 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00107383 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1841424967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 OAKLAND DR FL 3",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081282",
"telephone_number": "269-387-7004",
"fax_number": "269-387-7026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 OAKLAND DR FL 3",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490081282",
"telephone_number": "269-387-7004",
"fax_number": "269-387-7026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "RONALD",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-04",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "00107383",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE INSURANCE",
"identifier": "46-31868",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40-4702665",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.