Individual provider Active NPI

Kelsey Ann Kinnarney, SLP

  • Speech-Language Pathologist
  • Monrovia, IN
National Provider Identifier
1932511508
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 14874 Issued in FL
Practice address
2913 W Broderie LN
Monrovia, IN 46157-6131
Phone
(812) 929-1060
NPI assigned
May 29, 2014
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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 SA 14874 FL Primary

Addresses

Primary practice location

2913 W Broderie LN
Monrovia, IN 46157-6131

Mailing address

2913 W Broderie LN
Monrovia, IN 46157-6131
Phone (812) 929-1060

Other names 1

  • Mrs. Kelsey Ann Wagner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250917002570 IN Practitioner - Qualified Speech Language Pathologist 4385148907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 Horizon Dr
Suite 310
Raleigh, NC 27615-4926

2913 W Broderie LN
Monrovia, IN 46157-6131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA 14874FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jul 21, 2025 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince Jul 21, 2025 Accepting new patients
Kids Talk Place LLC Past Accepting new patients
Kids Talk Place LLC PastSince Oct 17, 2021 Accepting new patients

Locations

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1932511508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 W BRODERIE LN",
            "city": "MONROVIA",
            "state": "IN",
            "postal_code": "461576131",
            "telephone_number": "812-929-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 W BRODERIE LN",
            "city": "MONROVIA",
            "state": "IN",
            "postal_code": "461576131",
            "telephone_number": "812-929-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNARNEY",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA  14874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "WAGNER",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monrovia, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.