Individual provider Active NPI

Kiri Jefferson, M.A. CF-SLP

  • Speech-Language Pathologist
  • Waynesboro, VA
National Provider Identifier
1376099028
Registry record updated Mar 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202008281 Issued in VA
Practice address
200 West 12TH St
A1-100
Waynesboro, VA 22980-4771
Phone
(540) 941-5501
NPI assigned
Aug 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202008281 VA Primary

Addresses

Primary practice location

200 West 12TH St
A1-100
Waynesboro, VA 22980-4771

Mailing address

1102 Rose Hill Dr
Charlottesville, VA 22903-5128
Phone (434) 979-8628

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2202008281VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charleston Center, Inc Speech-Language Pathologist 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.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488585600000",
    "number": "1376099028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 ROSE HILL DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229035128",
            "telephone_number": "434-979-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST 12TH ST",
            "address_2": "A1-100",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229804771",
            "telephone_number": "540-941-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "KIRI",
        "credential": "M.A. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2017-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2017; 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.