Individual provider Active NPI

Kimberly Jo Woolard, MS, CCC-SLP

  • Speech-Language Pathologist
  • Pineville, NC
National Provider Identifier
1083976278
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9612 Issued in NC
Practice address
818 Traditions Park Dr
Pineville, NC 28134-7460
Phone
(704) 302-3830
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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 9612 NC Primary

Addresses

Primary practice location

818 Traditions Park Dr
Pineville, NC 28134-7460

Mailing address

818 Traditions Park Dr
Pineville, NC 28134-7460
Phone (704) 302-3830

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
9612NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1083976278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 TRADITIONS PARK DR",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281347460",
            "telephone_number": "704-302-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 TRADITIONS PARK DR",
            "city": "PINEVILLE",
            "state": "NC",
            "postal_code": "281347460",
            "telephone_number": "704-302-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLARD",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.