Kimberly Anne Porter, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 5070-SL Issued in MA

Practice address

619 South St
Fitchburg, MA 01420-6248

Phone

(978) 827-0757

Fax

(978) 703-4431

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1154501518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 SAW MILL POND RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014206041",
            "telephone_number": "978-827-0757",
            "fax_number": "978-703-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 SOUTH ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014206248",
            "telephone_number": "978-827-0757",
            "fax_number": "978-703-4431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 TUCKERMAN RD",
            "address_purpose": "LOCATION",
            "city": "ASHBURNHAM",
            "state": "MA",
            "postal_code": "014303051",
            "country_code": "US",
            "telephone_number": "978-833-1887",
            "fax_number": "978-252-5218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "SP 5070-SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Poirier, OPT
• Jonathan Polanco Soto
• Polaris Home Care Systems, LLC
• Wilder Ruben Poma
• Delaney Ponder
• Jennifer Potvin, BA
• Nichole Marie Preeper, CLINICAL INTERN
• Premier Pain Centers PLLC
• Premier Pain Management PLLC
• Preventive Medicine Associates

• Speech-Language Pathologist in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.