Jessica Roten Klamfoth, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9451 Issued in NC

Practice address

1730 Kernersville Medical Pkwy Ste 201
Kernersville, NC 27284-7198

Phone

(336) 994-7001

NPI assigned

Nov 10, 2011

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kidology, Inc

  • Physical Therapist
  • Lincolnton, NC
  • NPI 1730591991
  NPD

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043597545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791",
            "telephone_number": "336-996-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 201",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847198",
            "telephone_number": "336-994-7001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Arbor Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271041106",
            "country_code": "US",
            "telephone_number": "336-724-7921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1240 Arbor Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271041106",
            "country_code": "US",
            "telephone_number": "336-724-7921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLAMFOTH",
        "first_name": "JESSICA",
        "middle_name": "ROTEN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.