KELLY N ROUNDTREE (NPI# 1215583620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215583620 |
| Entity Type | Individual |
| Full Name | KELLY N ROUNDTREE |
| Credential | SLP |
| Practice Address |
15489 Dedeaux Rd Gulfport MS 39503-2667 |
| Practice Telephone | 2288060616 |
| Mailing Telephone | 2288060616 |
| Mailing Fax Number | 2288320800 |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | S2496 | MS | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MS SLP LICENSE | S2496 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 23272 Hwy 49 Frontage Rd, Saucier, MS 395746047 | 2288060616 |
| Street Address |
15489 DEDEAUX RD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-2667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366042897 | Shelby Hancock | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-10-26 |
| 1023624525 | Sarah Elizabeth Jones | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-20 |
| 1700492592 | Blaine Stiglets | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-17 |
| 1306452297 | Sarah Elizabeth Gorrell | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-09-16 |
| 1760091995 | Lauren Lee | Behavior Technician | 15489 Dedeaux Rd, Gulfport, MS 39503-2667 | 2020-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| 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 |
|---|---|---|---|---|
| 1609389105 | Karen R Burns | Speech-Language Pathologist | 3506 Washington Avenue, Ste E, Gulfport, MS 39507 | 2017-11-07 |
| 1437603925 | Brandy Flynn | Speech-Language Pathologist | 12257 Breezeway Cir, Gulfport, MS 39503-4010 | 2016-08-12 |
| 1750772067 | Traci Hydrick Collinsworth | Speech-Language Pathologist | 14057 Dunnbarton Dr, Gulfport, MS 39503-4998 | 2015-02-09 |
| 1063730315 | Carrie Joyce Payne-morris | Speech-Language Pathologist | 14553 S Country Wood Dr, Gulfport, MS 39503-8716 | 2010-05-12 |
| 1972826493 | Joan F Murphy | Speech-Language Pathologist | 11089 W Dogwood Dr, Gulfport, MS 39503-3842 | 2010-03-11 |
| 1558692905 | Janet Eugenie Mora | Speech-Language Pathologist | 11975 Seaway Rd Ste A226, Gulfport, MS 39503-6250 | 2010-01-25 |
| 1992030266 | Sonya Weekley Cowart | Speech-Language Pathologist | 16224 S Swan Rd, Gulfport, MS 39503-8004 | 2009-10-05 |
| 1578897047 | Billi J Sumrall | Speech-Language Pathologist | 13053 Woodbridge Ct, Gulfport, MS 39503-2483 | 2009-09-30 |
| 1437382108 | Katherine Alvarez | Speech-Language Pathologist | 9113 Cross Creek Pl, Gulfport, MS 39503-6116 | 2009-08-28 |
| 1194958868 | Allison C. Brown | Speech-Language Pathologist | 13500 Three Rivers Rd, Gulfport, MS 39503-5140 | 2009-08-28 |
| Find all providers in GULFPORT | ||||
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| 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.