IndividualActive
Kelley Bumgardaner, MA, CCC-SLP
NPI 1720154248 · Speech-Language Pathologist · Desloge, MO
Provider details
- NPI number
- 1720154248
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- MA, CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- License
- MO01965 (MO)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
801 Brim St
Desloge, MO 63601-3441
Phone: (573) 431-0223
Fax: (573) 431-0251
Street-level locationGet directions
Mailing address
Po Box 625
Fredericktown, MO 63645-0625
Registry dates
- Enumerated
- 2006-11-27
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.