NPIMap

Individual provider Active NPI

Kimberly Anne Macdonald

  • Speech-Language Pathologist
  • Boardman, OH
National Provider Identifier
1164655122
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP9491 Issued in OH
Practice address
7620 Southern Blvd
Suite 3
Boardman, OH 44512-5667
Phone
(330) 965-9330
Fax
(330) 965-9308
NPI assigned
Aug 25, 2009
Last updated
Aug 25, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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 SP9491 OH Primary

Addresses

Primary practice location

7620 Southern Blvd
Suite 3
Boardman, OH 44512-5667

Mailing address

7620 Southern Blvd
Suite 3
Boardman, OH 44512-5667
Phone (330) 965-9330

Other identifiers 1

IdentifierTypeStateIssuer
SP9491OtherOHSPEECH-LANGUAGE PATHOLOGIST

Other names 1

  • Kimberly Anne Sweed Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP9491OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwoods Rehabilitation LLC Speech-Language Pathologist Past Accepting new patients
Lock and Key ABA Therapy Group Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1164655122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 SOUTHERN BLVD",
            "address_2": "SUITE 3",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125667",
            "telephone_number": "330-965-9330",
            "fax_number": "330-965-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 SOUTHERN BLVD",
            "address_2": "SUITE 3",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125667",
            "telephone_number": "330-965-9330",
            "fax_number": "330-965-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP9491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGIST",
            "identifier": "SP9491",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SWEED",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.