Individual provider Active NPI

Gina Leslie Kimmey, MS,CCC-SLP

  • Speech-Language Pathologist
  • Pompano Beach, FL
National Provider Identifier
1376686881
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA5518 Issued in FL
Practice address
2840 NE 19TH St
Pompano Beach, FL 33062-3109
Phone
(954) 943-9589
Fax
(954) 943-4115
NPI assigned
Feb 14, 2007
Last updated
Dec 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA5518 FL Primary
Developmental Therapist 222Q00000X SA 5518 FL

Addresses

Primary practice location

2840 NE 19TH St
Pompano Beach, FL 33062-3109

Mailing address

2840 NE 19TH St
Pompano Beach, FL 33062-3109
Phone (954) 785-8052

Other identifiers 1

IdentifierTypeStateIssuer
890371900MedicaidFL

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 Science

State licenses

LicenseStateTypeSpecialty
SA 5518FLMDDevelopmental Therapist
SA5518FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1376686881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 NE 19TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623109",
            "telephone_number": "954-785-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 NE 19TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330623109",
            "telephone_number": "954-943-9589",
            "fax_number": "954-943-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEY",
        "first_name": "GINA",
        "middle_name": "LESLIE",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5518",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "SA 5518",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890371900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.