Deidre Ann Kondik, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-1555 Issued in WV

Practice address

4000 Out Look Dr
Hurricane, WV 25526-9467

Phone

(330) 338-8862

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1245358134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OUT LOOK DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269467",
            "telephone_number": "330-338-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OUT LOOK DR",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269467",
            "telephone_number": "330-338-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDIK",
        "first_name": "DEIDRE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP6401",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-1555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Audric King, M.D.
• Katherine Ellen King, PHARMD
• Nathan Earl Kirk II, DMD
• Tamra Dawn Kiser
• Tia Shea Knight
• Mahija Kottapalli, M.D.
• Amber Kunze
• Jane A Kurucz, M.D.
• Laboratory Corporation of America Holdings
• Eric Lambert, RPH

• Speech-Language Pathologist in Hurricane, WV
• Providers in Hurricane, WV by specialty
• Speech-Language Pathologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.