Kimberley Ady
Individual provider Active NPI Speech-Language Pathologist · Conway, SC
NPI 1043677594 · NPPES record last updated Jan 27, 2016
Key facts
- NPI
- 1043677594
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4054 (SC)
- Practice address
- 300 Singleton Ridge Rd
Conway, SC 29526-9142 - Phone
- (843) 347-8179
- NPI assigned
- Jan 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4054 | SC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medicos, P.a. | Past |
Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4054 | SC | Yes |
Addresses
Primary practice location
300 Singleton Ridge Rd
Conway, SC 29526-9142
Mailing address
2414 Airport Blvd
North Myrtle Beach, SC 29582-4316
Other providers in Conway, SC
- Mark R Adams
- James W Adamson
- Alicia Adcock
- Advanced GYN and Wellness
- Advanced Surgical Associates
- Agape Assisted Living of Conway, Inc,
- Agape Community Hospice of the Grand Strand Inc.
- Agape Hospice House of Horry County, Inc.
- Agape Rehabilitation of Conway, Inc.
- Radhica Agarwal
All providers in Conway, SC · Speech-Language Pathologist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.