Individual provider Active NPI

Kiera Rufus, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Myrtle Beach, SC
National Provider Identifier
1174247597
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8211 Issued in SC
Practice address
121 Gateway Rd Unit B
Myrtle Beach, SC 29579-5400
Phone
(843) 796-3964
Fax
(843) 503-4102
NPI assigned
Sep 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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 8211 SC Primary

Addresses

Primary practice location

121 Gateway Rd Unit B
Myrtle Beach, SC 29579-5400

Mailing address

121 Gateway Rd Unit B
Myrtle Beach, SC 29579-5400
Phone (843) 796-3964

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 Arts

State licenses

LicenseStateTypeSpecialty
8211SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Pediatric Therapy Speech-Language Pathologist PastSince Oct 2, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1174247597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 GATEWAY RD UNIT B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795400",
            "telephone_number": "843-796-3964",
            "fax_number": "843-796-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 GATEWAY RD UNIT B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795400",
            "telephone_number": "843-796-3964",
            "fax_number": "843-503-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFUS",
        "first_name": "KIERA",
        "name_prefix": "Miss",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.