Individual provider Active NPI

Kathleen Grimsley, SLP

  • Speech-Language Pathologist
  • Livonia, NY
National Provider Identifier
1376789834
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
018644-1 Issued in NY
Practice address
5691 McPhersons PT
Livonia, NY 14487-9210
Phone
(585) 734-6696
NPI assigned
Jan 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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 018644-1 NY Primary

Addresses

Primary practice location

5691 McPhersons PT
Livonia, NY 14487-9210

Mailing address

5691 McPhersons PT
Livonia, NY 14487-9210
Phone (585) 734-6696

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

State licenses

LicenseStateTypeSpecialty
018644-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1376789834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5691 MCPHERSONS PT",
            "city": "LIVONIA",
            "state": "NY",
            "postal_code": "144879210",
            "telephone_number": "585-734-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 MCPHERSONS PT",
            "city": "LIVONIA",
            "state": "NY",
            "postal_code": "144879210",
            "telephone_number": "585-734-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSLEY",
        "first_name": "KATHLEEN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-05",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018644-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.