Kimberly Keough, MS SPED

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

1311 Appeal Ave
Elmont, NY 11003-3302

Phone

(516) 451-6967

NPI assigned

Aug 1, 2017

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

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336663236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 APPEAL AVENUE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "516-451-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 APPEAL AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033302",
            "telephone_number": "516-451-6967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Austin St",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113751022",
            "country_code": "US",
            "telephone_number": "718-762-7633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEOUGH",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "MS SPED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.