Individual provider Active NPI

Kasandra C Richardson, MS, CCC-SLP

  • Speech-Language Pathologist
  • West Point, MS
National Provider Identifier
1134424153
Registry record updated Jan 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S3302 Issued in MS
Practice address
804 E Main St
West Point, MS 39773-3137
Phone
(662) 494-2006
NPI assigned
Jan 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2011

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 S3302 MS Primary

Addresses

Primary practice location

804 E Main St
West Point, MS 39773-3137

Mailing address

804 E Main St
West Point, MS 39773-3137
Phone (662) 494-2006

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
S3302MSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1295654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295654400000",
    "number": "1134424153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 E MAIN ST",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397733137",
            "telephone_number": "662-494-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E MAIN ST",
            "city": "WEST POINT",
            "state": "MS",
            "postal_code": "397733137",
            "telephone_number": "662-494-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "KASANDRA",
        "middle_name": "C",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-22",
        "last_updated": "2011-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Point, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2011; 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.