Kimberly A McDonnell, MS,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2002027404 Issued in MO

Practice address

1515 Midmeadow LN
Festus, MO 63028-1545

Phone

(636) 937-8044

NPI assigned

Jan 29, 2007

Last updated

Sep 10, 2021By the provider in NPPES

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

Other identifiers 3

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.

• Festus R-6 School District

  • Local Education Agency (LEA)
  • Festus, MO
  • NPI 1801047915
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1346386562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9829 ROUND TABLE CT",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630503973",
            "telephone_number": "314-540-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MIDMEADOW LN",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281545",
            "telephone_number": "636-937-8044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10560 Old Olive Street Rd",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Creve Coeur",
            "state": "MO",
            "postal_code": "631415916",
            "country_code": "US",
            "telephone_number": "314-567-4707",
            "fax_number": "314-567-4505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2002027404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1114090792",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507265809",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465964203",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin McCloskey, PMHNP-BC
• Lindsey Renee McColl, COTA/L
• McCullough Eyecare, PC
• Jarod Lance McCullough, O.D.
• Maxwell McDaniel, DPT
• John D McGarry, M.D.
• Ashliegh Marcella McGrath, CNP
• Linda C McKay
• Dana McKee
• Amanda Rae McVey, BSN, CCRN

• Speech-Language Pathologist in Festus, MO
• Providers in Festus, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.