Individual provider Active NPI

Kelly Ann Carbutt, M.S., CCC-SLP

  • Speech-Language Pathologist
  • King of Prussia, PA
National Provider Identifier
1972967735
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL012264 Issued in PA
Practice address
339 Crossfield Rd
King of Prussia, PA 19406-2286
Phone
(203) 241-8420
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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 SL012264 PA Primary

Addresses

Primary practice location

339 Crossfield Rd
King of Prussia, PA 19406-2286

Mailing address

339 Crossfield Rd
King of Prussia, PA 19406-2286
Phone (203) 241-8420

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL012264PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1972967735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CROSSFIELD RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062286",
            "telephone_number": "203-241-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CROSSFIELD RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062286",
            "telephone_number": "203-241-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBUTT",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.