Individual provider Active NPI

Kenneth Eugene Kuipers, MACCCSLP

  • Speech-Language Pathologist
  • Hamburg, PA
National Provider Identifier
1013039197
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL000463L Issued in PA
Practice address
125 Holly Rd
Hamburg, PA 19526-8729
Phone
(610) 562-2284
Fax
(610) 562-4938
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL000463L PA Primary

Addresses

Primary practice location

125 Holly Rd
Hamburg, PA 19526-8729

Mailing address

709 Williams St
Hamburg, PA 19526-1608
Phone (610) 562-3633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SL000463LPAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013039197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 WILLIAMS ST",
            "city": "HAMBURG",
            "state": "PA",
            "postal_code": "195261608",
            "telephone_number": "610-562-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HOLLY RD",
            "city": "HAMBURG",
            "state": "PA",
            "postal_code": "195268729",
            "telephone_number": "610-562-2284",
            "fax_number": "610-562-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUIPERS",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "credential": "MACCCSLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL000463L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.