Individual provider Active NPI

Kristen Laurel Lincoln

  • Speech-Language Pathologist
  • Kirksville, MO
National Provider Identifier
1295158673
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2013040773 Issued in MO
Practice address
1815 E Hamilton St
Kirksville, MO 63501-3903
Phone
(660) 665-5691
Fax
(660) 626-1421
NPI assigned
Jan 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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 2013040773 MO Primary

Addresses

Primary practice location

1815 E Hamilton St
Kirksville, MO 63501-3903

Mailing address

1901 E Hamilton St
Kirksville, MO 63501-3904
Phone (660) 665-7774

Other identifiers 2

IdentifierTypeStateIssuer
2013040773OtherMOMISSOURI STATE BOARD OF REGISTRATION FOR THE HELAING ARTS
SPEECH LANGUAGE PATHOtherMODEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013040773MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kirksville R-III Schools Past Accepting new patients
Kirksville Missouri Hospital Company, LLC Past Accepting new patients

Organizations & group practices 2

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": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1295158673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013904",
            "telephone_number": "660-665-7774",
            "fax_number": "660-665-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E HAMILTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013903",
            "telephone_number": "660-665-5691",
            "fax_number": "660-626-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINCOLN",
        "first_name": "KRISTEN",
        "middle_name": "LAUREL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2013040773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI STATE BOARD OF REGISTRATION FOR THE HELAING ARTS",
            "identifier": "2013040773",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION",
            "identifier": "SPEECH LANGUAGE PATH",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.