Kendria Coleman

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3192 Issued in MS

Practice address

4109 Hwy 98 W
Summit, MS 39666

Phone

(601) 276-3900

NPI assigned

Apr 2, 2009

Sex

Female

Sole proprietor

Yes

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.

• Graceful Talk Speech-Language Pathology Services

  • Speech-Language Pathologist
  • Hazlehurst, MS
  • NPI 1013710631

  MS, Speech-Language Pathologist

  Medicare reassignment NPD Authorized official

Specialty

Qualified Speech Language Pathologist

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 2, 2009.

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238630400000",
    "number": "1154563328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 W 7TH ST",
            "address_2": "APT 511",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 HWY 98 W",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "39666",
            "telephone_number": "601-276-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "KENDRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2009-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Clark
• Christy Cobb
• Thomas Chadwick Cochran, RD, LD
• Mitzi Cockrell
• Ann Marie Cole
• Collaborative Health and Rehabilitation Services, Inc
• Lacy Cooper
• Caleb Tanner Cothren
• Creative Connections, PLLC
• Merri Crisler

• All providers in Summit, MS
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.