KELLY ROBERTSON (NPI# 1104148451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104148451 |
| Entity Type | Individual |
| Full Name | KELLY ROBERTSON |
| Credential | M.A. CCC/SLP |
| Practice Address |
188 Evergreen Rd Lake Wylie SC 29710-9001 |
| Practice Telephone | 4076902056 |
| Mailing Telephone | 4076902056 |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2014-02-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 5367 | SC | Speech, Language and Hearing Service Providers |
| N | 235Z00000X | Speech-Language Pathologist | SA 9884 | FL | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001155200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946513 | Kelly Robertson | Pharmacist | 3901 Rainbow Blvd # Ms 4040, Kansas City, KS 66160-8500 | 2020-09-14 |
| 1336488006 | Kelly Robertson | Specialist/Technologist | 4428 Glenn Rose St, Fairfax, VA 22032-1227 | 2013-01-31 |
| 1154570398 | Kelly W. Robertson | Speech-Language Pathologist | 4228 Grand Marais Rd, Jennings, LA 70546-8273 | 2008-09-11 |
| 1942368246 | Kelly Jo Robertson | Optometrist | 3001 S 144th Street, Suite 2001, Omaha, NE 68144 | 2006-12-05 |
| 1487216875 | Kelly Elizabeth Robertson | Speech-Language Pathologist | 1229 County Farm Rd, Bedford, VA 24523-3131 | 2019-07-05 |
| 1194298448 | Kelly Christina Robertson | Registered Nurse | 2200 Childrens Way, Nashville, TN 37232-2635 | 2019-01-09 |
| 1326569955 | Kelly Robertson | Physician Assistant | 550 University Blvd, Indianapolis, IN 46202-5149 | 2017-07-05 |
| 1588013924 | Kelly Robertson | Music Therapist | 1331 118th Ave Se, 400, Bellevue, WA 98005-3890 | 2016-06-07 |
| 1568822500 | Kelly Robertson | Case Manager/Care Coordinator | 3999 Fort Campbell Blvd, Hopkinsville, KY 42240-4929 | 2016-03-03 |
| 1093141236 | Kelly Anne Robertson | Marriage & Family Therapist | 1519 S Gilbert St, Iowa City, IA 52240-4367 | 2013-09-19 |
| Street Address |
188 EVERGREEN RD |
| City | LAKE WYLIE |
| State | SC |
| Zip Code | 29710-9001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728243 | Jessica Pampalone | Pharmacist | 175 Sc-274, Lake Wylie, SC 29710 | 2018-08-02 |
| 1932628344 | Andrew Thomas Sullivan | Student in an Organized Health Care Education/Training Program | 106 Mccall Street, Clover, SC 29710 | 2017-09-18 |
| 1619423449 | Dental Professionals of South Carolina, P.C. | Dentist | 209 Latitude Lane, Clover, SC 29710 | 2016-08-31 |
| 1932538816 | Tara Mehta | Psychologist | 48 Fairway Rdg, Clover, SC 29710 | 2013-11-01 |
| 1710238795 | Hong N Mitchell | Pharmacist | 158 Hwy. 274, Lake Wylie, SC 29710 | 2012-10-01 |
| 1790948602 | Barbara Ellen Anslow-myers | Speech-Language Pathologist | 530 Little Cove Lane, Lake Wylie, SC 29710 | 2008-07-10 |
| 1720200884 | Lake Wylie | Assisted Living Facility | 4877 Charlotte Highway, Lake Wylie, SC 29710 | 2007-05-02 |
| 1790804581 | Phillip Russell Sanford | Pharmacist | 3272 Wicklow Ln, Clover, SC 29710 | 2007-03-29 |
| 1124158472 | Thomas N Stall Sr. | Dentist | 1100 Village Harbor Dr., Lake Wylie, SC 29710 | 2007-03-06 |
| 1043369457 | John Frank Ruocco | Dentist | 140 Highway 274, Clover, SC 29710 | 2007-01-09 |
| Find all providers in zip 29710 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922580299 | Tanisha Jalene Morrison | Speech-Language Pathologist | 252 Latitude Ln # 1035923, Lake Wylie, SC 29710-8150 | 2018-09-04 |
| 1629207121 | Lindsay Coleman Romich | Speech-Language Pathologist | 530 Little Cove Ln, Lake Wylie, SC 29710-8107 | 2009-07-07 |
| 1326299116 | Maureen Pilgrim Sell | Speech-Language Pathologist | 4877 Charlotte Hwy, Lake Wylie, SC 29710-8096 | 2008-10-10 |
| 1790948602 | Barbara Ellen Anslow-myers | Speech-Language Pathologist | 530 Little Cove Lane, Lake Wylie, SC 29710 | 2008-07-10 |
| 1316264799 | Barbara E. Anslow-myers, LLC | Speech-Language Pathologist | 530 Little Cove Ln, Lake Wylie, SC 29710-8107 | 2010-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306153 | Samantha Shaddix | Speech-Language Pathologist | 2848 Pleasant Rd Ste 1012848, Fort Mill, SC 29708-9490 | 2020-11-04 |
| 1245838044 | Jamilette Ojeda | Speech-Language Pathologist | 152 Mossy Oaks Ave, Goose Creek, SC 29445-3644 | 2020-10-14 |
| 1922606987 | Beyond Words Speech Therapy Services, LLC | Speech-Language Pathologist | 1765 Benelli St, Sumter, SC 29150-7102 | 2020-10-13 |
| 1427655596 | Charity R. Goings | Speech-Language Pathologist | 101 Saluda Pointe Dr Unit 612, Lexington, SC 29072-7061 | 2020-10-02 |
| 1578170841 | Megan Britt | Speech-Language Pathologist | 503 Anderson Dr, Darlington, SC 29532-2211 | 2020-09-30 |
| 1699382945 | Simpsonville Speech Therapy, LLC | Speech-Language Pathologist | 202 Beauclair Dr, Simpsonville, SC 29680-6902 | 2020-09-29 |
| 1821605965 | Rachel Duncan | Speech-Language Pathologist | 9730 Dorchester Rd Unit 206, Summerville, SC 29485-9034 | 2020-09-23 |
| 1326654153 | Jordyn Demont | Speech-Language Pathologist | 238 Morning Song St, Ridgeville, SC 29472-9236 | 2020-09-17 |
| 1972118362 | Stephanie Malika Smith | Speech-Language Pathologist | 1041 Rabon Pond Dr, Columbia, SC 29223-5866 | 2020-09-11 |
| 1689288581 | Easy Talk Pediatrics, LLC | Speech-Language Pathologist | 1643b Savannah Hwy # 202, Charleston, SC 29407-6256 | 2020-09-08 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WYLIE |
| Zip Code | 29710 |
Please comment or provide details below to improve the information on KELLY ROBERTSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.