Individual provider Active NPI

Kelynne M Pabin

  • Speech-Language Pathologist
  • Toledo, OH
National Provider Identifier
1972881449
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP10386 Issued in OH
Practice address
4747 290TH St
Toledo, OH 43611
Phone
(419) 671-6350
NPI assigned
Aug 1, 2011
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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 SP10386 OH Primary

Addresses

Primary practice location

4747 290TH St
Toledo, OH 43611

Mailing address

1609 N Summit St
Toledo, OH 43604-1806
Phone (419) 671-0001

Other practice location 1

3148 W Central Ave
Toledo, OH 43606-2920
Phone (419) 241-6219 ext. 221

Other identifiers 1

IdentifierTypeStateIssuer
0242872MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP10386OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Hearing and Speech Center Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1972881449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041806",
            "telephone_number": "419-671-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 290TH ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43611",
            "telephone_number": "419-671-6350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3148 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436062920",
            "country_code": "US",
            "telephone_number": "419-241-6219 x221",
            "fax_number": "419-241-5912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PABIN",
        "first_name": "KELYNNE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP10386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242872",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.