Kimberley Anne Funk, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3066 Issued in FL

Practice address

11401 Old Saint Augustine Rd
Jacksonville, FL 32258-1402

Phone

(904) 886-8450

NPI assigned

Aug 24, 2018

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

State licenses

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1316428790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BAYMEADOWS CIR E APT 1202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565501",
            "telephone_number": "904-574-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 OLD SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581402",
            "telephone_number": "904-886-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "KIMBERLEY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "3066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Wayne Funderburk, M.D.
• Ryan M Funderburk, AU.D.
• Sarah Katherine Funderburke, M.A., CCC-SLP
• Nairemis Fundora
• Gina Fungcharoen
• Madison Kimble Funk, CRNA
• Zackary McKain Funk, MD
• Tiara Funkhouser, PA
• Fups Dental, Inc.
• Paula Strange Fuqua, PHARM.D.

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.