Kimberly A Wynants, MS,CCC,SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

005649-1 Issued in NY

Practice address

17400 State RT. 22
Cherry Plain, NY 12040-0048

Phone

(518) 658-2515

NPI assigned

Dec 30, 2011

Last updated

Dec 30, 2011By the provider in NPPES

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)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Berlin Central School District

  • Local Education Agency (LEA)
  • Cherry Plain, NY
  • NPI 1386781987
  NPD (past)

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1174893606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 259",
            "city": "BERLIN",
            "state": "NY",
            "postal_code": "120220259",
            "telephone_number": "518-658-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 STATE RT. 22",
            "city": "CHERRY PLAIN",
            "state": "NY",
            "postal_code": "120400048",
            "telephone_number": "518-658-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNANTS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC,SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005649-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Anne Kaschak, RN
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• Kathleen E Smith, LPN
• Dorothy Louise Stall, LPN

• Speech-Language Pathologist in Cherry Plain, NY
• Providers in Cherry Plain, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.