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KELLY DECLARK
NPI 1841124740
Speech-Language Pathologist in Holly, MI

Active since June 09, 2026Accepts Medicare Assignment
10483 DIXIE HWY, HOLLY, MI 48442(810) 771-7686 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kelly Declark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY DECLARK (NPI 1841124740) is an individual speech-language pathologist provider in Holly, Michigan, licensed in Michigan (7152001440) and active in the NPI registry since June 2026. The provider is a graduate of Other (2026).

NPPES Registry Identity

NPI1841124740
Entity TypeIndividual
Primary Taxonomy235Z00000X
Provider Legal NameKELLY DECLARK
Location Address10483 DIXIE HWYHolly, MI 48442-9311
Mailing Address10483 Dixie HwyHolly, MI 48442-9311 · (810) 771-7686
Phone(810) 771-7686
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateJune 9, 2026
NPPES CertifiedJune 9, 2026
✔ NPI 1841124740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in MI · 7152001440
Definition
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.
10483 DIXIE HWY, Holly, MI 48442
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Declark is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890250765
PECOS Enrollment IDI20260721003614

Medicare Billing Reassignments

4

Medicare enrollment records show Kelly Declark reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Level 11 Physical Therapy
0.1 mi
Rehabilitation
10483 DIXIE HWY
Holly, MI 48442
  • Reassigned Medicare billing, Michigan enrollment
  • 39 clinicians in this Medicare group
NPI 1730317785 (810) 771-7686
Level Eleven Howell
24 mi
Rehabilitation
1030 W. HIGHLAND RD
Howell, MI 48843
  • Reassigned Medicare billing, Michigan enrollment
  • 33 clinicians in this Medicare group
NPI 1174998801 (810) 771-7686
Rww Outpatient Rehab Services, LLC
38 mi
Physical Therapist
13331 15 MILE RD
Sterling Heights, MI 48312
  • Reassigned Medicare billing, Michigan enrollment
  • 33 clinicians in this Medicare group
NPI 1457990061 (586) 978-0376
Level Eleven Saginaw
47 mi
Physical Therapy
5815 BAY RD, SUITE 400
Saginaw, MI 48604
  • Reassigned Medicare billing, Michigan enrollment
  • 31 clinicians in this Medicare group
NPI 1720320583 (810) 771-7686

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABIGAIL ANNE HEREAU PT, DPT, ATC
Physical Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 498-2301
ANNA MARIE BRADLEY PT, DPT
Physical Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 771-7686
HEATHER HEPPER PT, DPT
Physical Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 771-7686
TERESA RENEE FINNIGAN
Speech-Language Pathologist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 771-7685
AUDREY PLOUFFE
Physical Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 771-7686
KAITLYN LANDESS OTD, OTR/L
Occupational Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 771-7686
MEGAN ANTAYA SCHMIDT OTR/L
Occupational Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 498-2301
ERIN UEHARA
Physical Therapist
10483 DIXIE HWY
HOLLY, MI 48442
Oakland County (810) 771-7686

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Declark's NPI number?

The NPI number for Kelly Declark is 1841124740. It was assigned to this individual provider in the NPPES registry on June 9, 2026.

Where is Kelly Declark located?

Kelly Declark practices at 10483 Dixie Hwy, Holly, MI 48442. The listed phone number is (810) 771-7686.

What is Kelly Declark's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Kelly Declark enrolled in Medicare?

Yes. Kelly Declark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Declark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Declark reassigns Medicare benefits to 4 organizations: Level 11 Physical Therapy (Holly, MI), Level Eleven Howell (Howell, MI), Rww Outpatient Rehab Services, LLC (Sterling Heights, MI) and Level Eleven Saginaw (Saginaw, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Declark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Declark was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.