Individual provider Active NPI

Kimberly R Myers, MSCCC-SLP-L

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1093919342
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1001 Issued in ND
Practice address
Fargo Public Schools
700 7TH St S
Fargo, ND 58103
Phone
(701) 446-1000
Fax
(701) 446-1200
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1144 MT
Speech-Language Pathologist 235Z00000X 1001 ND Primary

Addresses

Primary practice location

Fargo Public Schools
700 7TH St S
Fargo, ND 58103

Mailing address

2506 34TH Ave S
Fargo, ND 58104-8803
Phone (701) 306-5829

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

LicenseStateTypeSpecialty
1144MTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fargo Public Schools Speech-Language Pathologist CurrentSince Mar 31, 2024 Accepting new patients
Eugene F Herman Scottish Rite Childhood Language Disorders Clinic Speech-Language Pathologist Past Accepting new patients
Pediatric Therapy Clinic Speech-Language Pathologist Past Accepting new patients

Locations

700 7th St S
Fargo, ND 58103
Phone (701) 446-1000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1093919342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 34TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048803",
            "telephone_number": "701-306-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FARGO PUBLIC SCHOOLS",
            "address_2": "700 7TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-446-1000",
            "fax_number": "701-446-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MSCCC-SLP-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "1144",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.