Active NPI
Kim Ellen Weisensee, SLP
- Speech-Language Pathologist
- Lowell, MA
National Provider Identifier
1326228784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3677
- Practice address
- 126 Phoenix Ave BLDG 2
Lowell, MA 01852-4931 - Phone
- (978) 453-8331
- NPI assigned
- Nov 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3677 | MA | Primary |
Addresses
Primary practice location
126 Phoenix Ave BLDG 2
Lowell, MA 01852-4931
Mailing address
126 Phoenix Ave BLDG 2
Lowell, MA 01852-4931
Phone (978) 453-8331
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3677 | MA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglas a. Thom Clinic, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Developmental Disabilities Clinic/Center
- Lowell, MA
- NPI 1396771820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1326228784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 PHOENIX AVE BLDG 2",
"city": "LOWELL",
"state": "MA",
"postal_code": "018524931",
"telephone_number": "978-453-8331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 PHOENIX AVE BLDG 2",
"city": "LOWELL",
"state": "MA",
"postal_code": "018524931",
"telephone_number": "978-453-8331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISENSEE",
"first_name": "KIM",
"middle_name": "ELLEN",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-13",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "3677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.