Individual provider Active NPI

Kelly Leigh Alix, CCC-SLP

  • Speech-Language Pathologist
  • Brooklyn, NY
National Provider Identifier
1891001640
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015621-1 Issued in NY
Practice address
275 Park Ave
Apt. 4B
Brooklyn, NY 11205-2555
Phone
(401) 345-5061
NPI assigned
Aug 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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 015621-1 NY Primary

Addresses

Primary practice location

275 Park Ave
Apt. 4B
Brooklyn, NY 11205-2555

Mailing address

275 Park Ave
Apt. 4B
Brooklyn, NY 11205-2555
Phone (401) 345-5061

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
015621-1NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1891001640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 PARK AVE",
            "address_2": "APT. 4B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052555",
            "telephone_number": "401-345-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PARK AVE",
            "address_2": "APT. 4B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052555",
            "telephone_number": "401-345-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALIX",
        "first_name": "KELLY",
        "middle_name": "LEIGH",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015621-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.