Active NPI
Kathleen Elam Rockwell, SPEECH AND LANGUAGE
- Speech-Language Pathologist
- Ballwin, MO
National Provider Identifier
1851711451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- M461666505
- Practice address
- 1917 Powderhorn Pass CT
Ballwin, MO 63011-1717 - Phone
- (636) 236-7806
- NPI assigned
- Apr 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | M461666505 | MO | Primary |
Addresses
Primary practice location
1917 Powderhorn Pass CT
Ballwin, MO 63011-1717
Mailing address
1917 Powderhorn Pass CT
Wildwood, MO 63011-1717
Phone (636) 236-7806
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M461666505 | Other | MO | MO HEALTHNET NATIONAL PROVIDER IDENTIFIER |
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 |
|---|---|---|---|
| M461666505 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398124800000",
"number": "1851711451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1917 POWDERHORN PASS CT",
"city": "WILDWOOD",
"state": "MO",
"postal_code": "630111717",
"telephone_number": "636-236-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1917 POWDERHORN PASS CT",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630111717",
"telephone_number": "636-236-7806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCKWELL",
"first_name": "KATHLEEN",
"middle_name": "ELAM",
"name_prefix": "Mrs.",
"credential": "SPEECH AND LANGUAGE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-22",
"last_updated": "2014-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "M461666505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO HEALTHNET NATIONAL PROVIDER IDENTIFIER",
"identifier": "M461666505",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.