Active NPI
Kimberly Ann Phippen, CCC, SLP
- Speech-Language Pathologist
- Seaside, CA
National Provider Identifier
1073225702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 33929
- Practice address
- 500 Nijmegen Rd
Seaside, CA 93955-6763 - Phone
- (209) 247-2585
- NPI assigned
- Dec 13, 2022
- 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 | 33929 | CA | Primary |
Addresses
Primary practice location
500 Nijmegen Rd
Seaside, CA 93955-6763
Mailing address
500 Nijmegen Rd
Seaside, CA 93955-6763
Phone (209) 247-2585
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 |
|---|---|---|---|
| 33929 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1073225702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 NIJMEGEN RD",
"city": "SEASIDE",
"state": "CA",
"postal_code": "939556763",
"telephone_number": "209-247-2585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 NIJMEGEN RD",
"city": "SEASIDE",
"state": "CA",
"postal_code": "939556763",
"telephone_number": "209-247-2585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHIPPEN",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "CCC, SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-13",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "33929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seaside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.