Kimberley Coore-Powell Fox, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5190 Issued in FL

Practice address

1103 E Jasmine Lane
North Lauderdale, FL 33068-3952

Phone

(954) 649-9397

Fax

(954) 917-9397

NPI assigned

Nov 2, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073691416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 E JASMINE LANE",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330683952",
            "telephone_number": "954-649-9397",
            "fax_number": "954-917-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 E JASMINE LANE",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330683952",
            "telephone_number": "954-649-9397",
            "fax_number": "954-917-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COORE-POWELL FOX",
        "first_name": "KIMBERLEY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886264896",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886264800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in North Lauderdale, FL
• Providers in North Lauderdale, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.