Active NPI
Christine Sanders Kelly, SLP
- Speech-Language Pathologist
- Wayne, WV
National Provider Identifier
1992946701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-2310
- Practice address
- 212 North Court Street
Wayne, WV 25570 - Phone
- (304) 272-5116
- Fax
- (304) 272-5993
- NPI assigned
- Mar 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP-2310 | WV | Primary |
Addresses
Primary practice location
212 North Court Street
Wayne, WV 25570
Mailing address
484 Main Street
Ceredo, WV 25507
Phone (304) 272-5116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810013621 | Medicaid | WV |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-2310 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1992946701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "484 MAIN STREET",
"city": "CEREDO",
"state": "WV",
"postal_code": "25507",
"telephone_number": "304-272-5116",
"fax_number": "304-272-5993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 NORTH COURT STREET",
"city": "WAYNE",
"state": "WV",
"postal_code": "25570",
"telephone_number": "304-272-5116",
"fax_number": "304-272-5993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "CHRISTINE",
"middle_name": "SANDERS",
"name_prefix": "Ms.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "SLP-2310",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810013621",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.