Kristina L Kelly, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA11782 Issued in FL

Practice address

12773 Forest Hill Blvd
Suite 217
Wellington, FL 33414-4767

Phone

(207) 798-0746

NPI assigned

Jun 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saco Bay Orthopaedic and Sports Physical Therapy, Inc

  • Physical Therapist
  • Saco, ME
  • NPI 1346254315

  ME

  Medicare reassignment NPD
• Saco Bay Orthopaedic and Sports Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Westbrook, ME
  • NPI 1396312807
  NPD
• Saco Bay Orthopaedic and Sports Physical Therapy, Inc.

  • Rehabilitation Clinic/Center
  • Portland, ME
  • NPI 1942850854
  NPD

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1902002157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12773 FOREST HILL BLVD",
            "address_2": "SUITE 217",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144767",
            "telephone_number": "207-798-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12773 FOREST HILL BLVD",
            "address_2": "SUITE 217",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144767",
            "telephone_number": "207-798-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11342698",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sukhpreet Kaur, MD
• Mariana Ernestina Kaviany
• Kayla Anthony MD LLC
• Kayscare LLC
• Kevin T Kelly, MD
• Teresa Ann Kelly, DPT
• Joan E Keltgen, ED.S
• Bridget I Keltner, LMHC
• Blake L Kendall, DO
• Jay Kernus, DO

• All providers in Wellington, FL
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.