Kimberly Ann Bancale, M.S. CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10704 Issued in NC

Practice address

1350 East Arlington Blvd Ste. a
Kinetic Physical Therapy and Wellness
Greenville, NC 27858

Phone

(252) 364-2806

NPI assigned

May 16, 2014

Last updated

Aug 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kinetic Phys Therapy and Wellness Inc

  • Physical Therapy Clinic/Center
  • Greenville, NC
  • NPI 1063733442
  NPD (past)

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1326459900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E 2ND ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "27889",
            "telephone_number": "252-216-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 EAST ARLINGTON BLVD STE. A",
            "address_2": "KINETIC PHYSICAL THERAPY AND WELLNESS",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-364-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANCALE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "M.S. CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A Ballance Jr., M.D.
• Alyssa Lauren Ballestero, FNP-C
• Maria Isabel Baltar de Barros Rego, DMD
• Richard J Baltaro, M.D.
• Renee Marie Banaszak, MD
• Amanda Bandy
• Susan Bane, MD
• Prarthana Bangalore Parthasarathy
• Elizabeth C Banks, PHD
• Tamara T Bantom

• Speech-Language Pathologist in Greenville, NC
• Providers in Greenville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.