Kelly Chan

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

15050 14TH Rd
Whitestone, NY 11357-2609

Phone

(718) 767-0071

NPI assigned

Dec 9, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Sprout Speech PLLC

  • Speech-Language Pathologist
  • Forest Hills, NY
  • NPI 1497545693
  NPD Authorized official

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1902271372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 147TH PL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543234",
            "telephone_number": "718-757-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15050 14TH RD",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572609",
            "telephone_number": "718-767-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Chamorro
• Maria Champion
• Tempii Champion
• Chau Sim Chan, DMD
• David Chan
• Vivian Chan
• Jennifer Chang
• Thomas Chang, DPT
• Dana M Chapyak, OTR/L
• Rebecca Charidemou, OTD

• Speech-Language Pathologist in Whitestone, NY
• Providers in Whitestone, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.