Kellie Elizabeth Green, M.A., CCC-SLP, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-310957 Issued in OH

Practice address

3600 Olentangy River Rd
BLDG D, Ste 107
Columbus, OH 43214-3437

Phone

(614) 974-2211

NPI assigned

Jan 2, 2009

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

Credentials

Master of Arts

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.

• K E Green Speech and Language LLC

  • Speech-Language Pathologist
  • Columbus, OH
  • NPI 1568837375
  NPD Authorized official
• K E Green Speech and Language LLC

  • Lactation Consultant (Non-RN)
  • Columbus, OH
  • NPI 1740928316

  Lactation Consultant, Non-RN

  NPD Authorized official

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1912143512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 WINDING WOODS DR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658180",
            "telephone_number": "614-342-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OLENTANGY RIVER RD",
            "address_2": "BLDG D, STE 107",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143437",
            "telephone_number": "614-974-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KELLIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-02",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.9217",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "OH",
            "license": "L-310957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Green
• Kacy Green
• Kamaron Green
• Kathy Lynn Green
• Katricia Green, RPH
• Kelly Green, MSW, LISW
• Kelly Green
• Kenyahtha Rayshiona Green
• Kimberly Michelle Green, D.O.
• Laura Vanessa Green I

• Lactation Consultant (Non-RN) in Columbus, OH
• Providers in Columbus, OH by specialty
• Lactation Consultant (Non-RN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.