Kailey Nicole Jo, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101006090 Issued in MI

Practice address

710 Kenmoor Ave SE Ste 110
Grand Rapids, MI 49546-2379

Phone

(616) 591-2905

Fax

(616) 333-2321

NPI assigned

Aug 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Paper Plane Therapies, LLC

  • Pediatric Occupational Therapist
  • Grand Rapids, MI
  • NPI 1073975645
  NPD (past)

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

{
    "created_epoch": "1596326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1912517244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 MILL POINT CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495129363",
            "telephone_number": "616-307-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KENMOOR AVE SE STE 110",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462379",
            "telephone_number": "616-591-2905",
            "fax_number": "616-333-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "KAILEY",
        "middle_name": "NICOLE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-02",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101006090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latroya Erica Jinwright
• Grace Makenna Jipping, PHARMD
• JKG Counseling & Recovery LLC
• JLS Counseling & Mentoring LLC
• Jo Kelly Counseling Services LLC
• Joanne Marie Grzeszak DO PC
• Francis G Jocis
• Joe Martino Counseling
• Joe Martino Counseling Grandville
• Courtney Joesel, M.A. CCC-SLP

• Speech-Language Pathologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.