Active NPI
Kimala Winger Bolden, MACCC-SLP
- Speech-Language Pathologist
- Lafayette, LA
National Provider Identifier
1053438150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3248
- Practice address
- 232 Ivory Street
Lafayette, LA 70506 - Phone
- (504) 554-0765
- Fax
- (337) 504-4961
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3248 | LA | Primary |
Addresses
Primary practice location
232 Ivory Street
Lafayette, LA 70506
Mailing address
232 Ivory Street
Lafayette, LA 70506
Phone (337) 504-2498
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3248 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053438150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 IVORY STREET",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70506",
"telephone_number": "337-504-2498",
"fax_number": "337-504-4961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 IVORY STREET",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70506",
"telephone_number": "504-554-0765",
"fax_number": "337-504-4961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "KIMALA",
"middle_name": "WINGER",
"name_prefix": "Mrs.",
"credential": "MACCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "3248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
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.