Kimberly B Wallace

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

AR#521 Issued in AR

Legal business name

KIMBERLY B WALLACE

Practice address

7000 Valley Dr
Little Rock, AR 72209-7522

Phone

(501) 447-6844

NPI assigned

Aug 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kimberly B. Wallace, M.S., CCC-SLP

Title

Speech Pathologist

Phone

(501) 447-6844

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1194971507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SHAMROCK DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722076027",
            "telephone_number": "501-416-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 VALLEY DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722097522",
            "telephone_number": "501-447-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY B WALLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "501-447-6844",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "AR#521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BOARD OF EXAMINERS IN SPEECH PATHOLOGY & AUDIOLOGY LICENSE",
            "identifier": "SP#521",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicola Kim, MD
• Peter Joo Kim, MD
• Joan Ruguru Kimani, MD
• Shane P Kimball, D.O.
• Jillian Kimberlain, AU.D.
• Keanna Kimble, PHARMD.
• Brittanya Kimbrew-James, CRT
• Kayla Kimbrough
• Mary K Kimbrough, MD
• Cecile W Kimmer, PT

• Speech-Language Pathologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.