KELLEY STORK (NPI# 1194292334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194292334 |
| Entity Type | Individual |
| Full Name | KELLEY STORK |
| Other Name | KELLEY FORD |
| Practice Address |
807 W Columbia Terrace Peoria IL 61606 |
| Mailing Address |
389 Illini Drive Hopewell IL 61565 |
| Practice Telephone | 3096822693 |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Street Address |
807 W COLUMBIA TERRACE |
| City | PEORIA |
| State | IL |
| Zip Code | 61606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1316492432 | Jennifer Greenwood | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2016-08-18 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1023062312 | Saint Francis Medical Center | Physical Medicine & Rehabilitation | 100 Ne Randoph Street, Peoria, IL 61606 | 2006-05-20 |
| 1174573307 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 741 West Main Street, Peoria, IL 61606 | 2006-05-10 |
| 1174025357 | Amy M Durst | Nurse Practitioner | 1001 Main St Ste 500a, Peoria, IL 61606 | 2018-03-05 |
| 1538471099 | Jacob Royle Hopping | Surgery | 1001 Main St Ste 300, Peoria, IL 61606 | 2010-07-12 |
| 1881906410 | Heather Jefford | Clinical Nurse Specialist | 1001 Main St, 3rd Floor, Peoria, IL 61606 | 2010-07-12 |
| 1306874128 | David L Crawford | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| 1205864170 | Norman C Estes | Surgery | 1001 Main Street, Suite 300, Peoria, IL 61606 | 2006-06-29 |
| Find all providers in zip 61606 | ||||
| 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 |
|---|---|---|---|---|
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1558916676 | Ashlyn Logston | Speech-Language Pathologist | 8092 W Paradise Ln Apt 1097, Peoria, AZ 85382-4982 | 2019-08-06 |
| 1700443074 | Julie Ann Kelly | Speech-Language Pathologist | 1619 W Fredonia Ave, Peoria, IL 61606-1664 | 2019-05-22 |
| 1619441342 | Jean Marie Bachman | Speech-Language Pathologist | 918 W Florence Ave, Peoria, IL 61604-1304 | 2019-01-16 |
| 1780155697 | Alexandra Marie Jones | Speech-Language Pathologist | 2315 N Sterling Ave, Peoria, IL 61604-3124 | 2018-12-17 |
| 1760951412 | Casey Lyn Janko | Speech-Language Pathologist | 5409 N Knoxville Ave Ste 103, Peoria, IL 61614-5069 | 2018-11-23 |
| 1689140519 | Emma Cristine Tully | Speech-Language Pathologist | 1619 W. Fredonia Ave, Peoria, IL 61606 | 2018-10-18 |
| 1982179123 | Jenny R. Doering | Speech-Language Pathologist | 4603 N Knoxville Ave, Peoria, IL 61614-6107 | 2018-10-03 |
| 1356825418 | Anne M Hall | Speech-Language Pathologist | 700 Mary St, Peoria, IL 61603-3432 | 2018-09-24 |
| 1407330947 | Shanna Boyer | Speech-Language Pathologist | 1819 W Northmoor Rd, Peoria, IL 61614-3332 | 2018-09-20 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on KELLEY STORK.
| 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.