Active NPI
Kim S Outlaw, OTR/L
- Specialist
- Kannapolis, NC
National Provider Identifier
1386897742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 5693
- Practice address
- 1909 S Cannon Blvd
Kannapolis, NC 28083-6107 - Phone
- (704) 938-1400
- Fax
- (704) 938-5892
- NPI assigned
- Oct 29, 2008
- Last updated
- Oct 29, 2008
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 5693 | NC | Primary |
Addresses
Primary practice location
1909 S Cannon Blvd
Kannapolis, NC 28083-6107
Mailing address
1909 S Cannon Blvd
Kannapolis, NC 28083-6107
Phone (704) 938-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5693 | Other | NC | NORTH CAROLINA STATE BOARD OF OT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5693 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1386897742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 S CANNON BLVD",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280836107",
"telephone_number": "704-938-1400",
"fax_number": "704-938-5892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 S CANNON BLVD",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280836107",
"telephone_number": "704-938-1400",
"fax_number": "704-938-5892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTLAW",
"first_name": "KIM",
"middle_name": "S",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-29",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "5693",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA STATE BOARD OF OT",
"identifier": "5693",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kannapolis, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.