Individual provider Active NPI

Joann Kmiecik, MA/CCC-SP

  • Speech-Language Pathologist
  • Cleveland, OH
National Provider Identifier
1386354181
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.03961 Issued in OH
Practice address
Head and Neck Institute 9500 Euclid Avenue
Cleveland, OH 44195-0001
Phone
(216) 272-7020
Fax
(216) 445-9409
NPI assigned
Dec 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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 SP.03961 OH Primary

Addresses

Primary practice location

Head and Neck Institute 9500 Euclid Avenue
Cleveland, OH 44195-0001

Mailing address

11906 Greyfriars Cir
North Royalton, OH 44133-6129
Phone (216) 272-7020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KmiecikJ@ccf.org Direct

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
SP.03961OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1386354181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11906 GREYFRIARS CIR",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441336129",
            "telephone_number": "216-272-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEAD AND NECK INSTITUTE 9500 EUCLID AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-272-7020",
            "fax_number": "216-445-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KMIECIK",
        "first_name": "JOANN",
        "credential": "MA/CCC-SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.03961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KmiecikJ@ccf.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email is all we use",
            "address_1": "Head and Neck Institute 9500 Euclid Avenue",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441950001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

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

Verify at the official NPI Registry.