Kennebec Speech Therapy PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

KENNEBEC SPEECH THERAPY PLLC

Practice address

5 Community Dr Ste 101
Augusta, ME 04330-8087

Phone

(207) 931-6319

Fax

(207) 512-1727

NPI assigned

May 17, 2021

Last updated

Feb 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Reily, M.A. CCC-SLPNPI 1174697429

Title

Speech Language Pathologist

Phone

(207) 931-6319

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Rose Reily, MA, CCC-SLP

  • Speech-Language Pathologist
  • Winthrop, ME
  • NPI 1174697429
  NPD Authorized official

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1376117093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 STANLEY RD",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043643336",
            "telephone_number": "207-931-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COMMUNITY DR STE 101",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308087",
            "telephone_number": "207-931-6319",
            "fax_number": "207-512-1727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Stanley Rd",
            "address_purpose": "LOCATION",
            "city": "Winthrop",
            "state": "ME",
            "postal_code": "043643336",
            "country_code": "US",
            "telephone_number": "207-931-6319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Child Development Services 146 State House Station",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043333336",
            "country_code": "US",
            "telephone_number": "207-624-6660",
            "fax_number": "207-624-6661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENNEBEC SPEECH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "REILY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "207-931-6319",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Augusta, ME
• Providers in Augusta, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.