Active NPI
Kimberly Arnold
- Speech-Language Pathologist
- Lake Mary, FL
National Provider Identifier
1164880233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA15474
- Practice address
- 756 N Sun Dr
Lake Mary, FL 32746-2507 - Phone
- (407) 852-3300
- NPI assigned
- Feb 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA15474 | FL | Primary |
Addresses
Primary practice location
756 N Sun Dr
Lake Mary, FL 32746-2507
Mailing address
1325 Druid Isle Rd
Maitland, FL 32751-4224
Phone (207) 415-6224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016677600 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA15474 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1164880233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 DRUID ISLE RD",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327514224",
"telephone_number": "207-415-6224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "756 N SUN DR",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462507",
"telephone_number": "407-852-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARNOLD",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-04",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA15474",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016677600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.