Individual provider Active NPI

Kelly Marie Simonett, SLP

  • Speech-Language Pathologist
  • Overland Park, KS
National Provider Identifier
1982994174
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2971 Issued in KS
Practice address
5211 W 103Rd St
Overland Park, KS 66207-3154
Phone
(913) 383-2569
Fax
(913) 383-2611
NPI assigned
Apr 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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 2971 KS Primary

Addresses

Primary practice location

5211 W 103Rd St
Overland Park, KS 66207-3154

Mailing address

6143 W 120TH St
Apt 91
Overland Park, KS 66209-3726
Phone (316) 640-2406

Other names 1

  • Kelly Marie Cook Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909001208 KS Practitioner - Qualified Speech Language Pathologist 1658777180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Wellness Kansas City, LLCGroup PAC ID 9830504836, 152 clinicians

Practice addresses (Care Compare)

4100 W 85TH St
Prairie Village, KS 66206-2166
Phone (913) 412-3745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Missouri LLC Speech-Language Pathologist CurrentSince Sep 27, 2024 Accepting new patients
Empowerme Rehabilitation Missouri LLC Speech-Language Pathologist CurrentSince Sep 27, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Sep 13, 2021 Accepting new patients
Empowerme Wellness Kansas City, LLC Speech-Language Pathologist CurrentSince Sep 13, 2021 Accepting new patients

Locations

2700 Somerset Dr
Prairie Village, KS 66206
Phone (913) 276-0901

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1982994174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 W 120TH ST",
            "address_2": "APT 91",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093726",
            "telephone_number": "316-640-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 W 103RD ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662073154",
            "telephone_number": "913-383-2569",
            "fax_number": "913-383-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETT",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "COOK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.