Individual provider Active NPI

Cindy Kaye Grimes, MS CCC/SLP

  • Speech-Language Pathologist
  • Beaumont, TX
National Provider Identifier
1083339063
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16686 Issued in TX
Practice address
23395 Burrell Wingate Rd
Beaumont, TX 77705-9182
Phone
(409) 794-1412
NPI assigned
Oct 11, 2022
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16686 TX Primary

Addresses

Primary practice location

23395 Burrell Wingate Rd
Beaumont, TX 77705-9182

Mailing address

23395 Burrell Wingate Rd
Beaumont, TX 77705-9182
Phone (409) 794-1412

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16686TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1083339063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23395 BURRELL WINGATE RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777059182",
            "telephone_number": "409-794-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23395 BURRELL WINGATE RD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777059182",
            "telephone_number": "409-794-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "CINDY",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "16686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.

Verify at the official NPI Registry.