Individual provider Active NPI

Kimberly A Myers

  • Speech-Language Pathologist
  • Little Rock, AR
National Provider Identifier
1295539674
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP467 Issued in AR
Practice address
9500 Baptist Health Dr Ste 210-a
Little Rock, AR 72205-6319
Phone
(501) 202-4630
Fax
(501) 202-4635
NPI assigned
Apr 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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 SP467 AR Primary

Addresses

Primary practice location

9500 Baptist Health Dr Ste 210-a
Little Rock, AR 72205-6319

Mailing address

11001 Executive Center Dr Ste 200
Little Rock, AR 72211-4393
Phone (501) 202-4630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428000069 AR Practitioner - Qualified Speech Language Pathologist 9931625597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

9800 Baptist Health Dr
Suite 400
Little Rock, AR 72205-6238
Phone (501) 202-4630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP467ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Speech-Language Pathologist CurrentSince Apr 1, 2025 Accepting new patients
Arkansas Health Group CurrentSince Apr 1, 2025 Accepting new patients

Locations

9800 Baptist Health Dr
Ste 400
Little Rock, AR 72205
Phone (501) 202-4630

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

9500 Kanis Rd
Ste 410
Little Rock, AR 72205
Phone (501) 202-1500

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": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1295539674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114393",
            "telephone_number": "501-202-4630",
            "fax_number": "501-202-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 BAPTIST HEALTH DR STE 210-A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056319",
            "telephone_number": "501-202-4630",
            "fax_number": "501-202-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.