Active NPI
Kimberly Denise Nahom, MS, CCC-SLP
- Speech-Language Pathologist
- Fairfax, VA
National Provider Identifier
1386305498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202002681
- Practice address
- 4310 Forest Hill Dr
Fairfax, VA 22030-5680 - Phone
- (703) 278-1001
- NPI assigned
- Jan 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202002681 | VA | Primary |
Addresses
Primary practice location
4310 Forest Hill Dr
Fairfax, VA 22030-5680
Mailing address
3507 Schuerman House Dr
Fairfax, VA 22031-4728
Phone (850) 543-3292
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202002681 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641081600000",
"number": "1386305498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3507 SCHUERMAN HOUSE DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220314728",
"telephone_number": "850-543-3292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 FOREST HILL DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220305680",
"telephone_number": "703-278-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAHOM",
"first_name": "KIMBERLY",
"middle_name": "DENISE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-02",
"last_updated": "2022-01-02",
"certification_date": "2022-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202002681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.