Kimberly Park, CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

401 Matt Waller Dr
Richmond, MO 64085-2270

Phone

(816) 776-3059

Fax

(816) 776-2608

NPI assigned

Jun 28, 2019

Last updated

Jun 28, 2019By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1366004491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W 14TH ST",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "646331926",
            "telephone_number": "660-349-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATT WALLER DR",
            "city": "RICHMOND",
            "state": "MO",
            "postal_code": "640852270",
            "telephone_number": "816-776-3059",
            "fax_number": "816-776-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpark@richmond.k12.mo.us",
            "affiliation": "N",
            "endpointDescription": "School email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email account",
            "address_1": "401 Matt Waller Dr",
            "city": "Richmond",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640852270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Richmond, MO
• Providers in Richmond, 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 Jun 28, 2019; 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.