Individual provider Active NPI

Kimberly Marie Dearing, MACCCSLP

  • Speech-Language Pathologist
  • Hurricane, WV
National Provider Identifier
1023353232
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0523 Issued in WV
Practice address
300 Seville Rd
Hurricane, WV 25526-9206
Phone
(304) 757-6805
NPI assigned
Nov 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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 0523 WV Primary

Addresses

Primary practice location

300 Seville Rd
Hurricane, WV 25526-9206

Mailing address

300 Seville Rd
Hurricane, WV 25526-9206
Phone (304) 757-6805

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
0523WVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1023353232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SEVILLE RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269206",
            "telephone_number": "304-757-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SEVILLE RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269206",
            "telephone_number": "304-757-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARING",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MACCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "0523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.