Active NPI
Kimberly Demichele, M.A. CCC-SLP
- Speech-Language Pathologist
- Lebanon, OH
National Provider Identifier
1417375494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.6144
- Practice address
- 439 Lake Shore Dr
Lebanon, OH 45036-7929 - Phone
- (513) 228-0025
- NPI assigned
- Apr 7, 2014
- 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 | SP.6144 | OH | Primary |
Addresses
Primary practice location
439 Lake Shore Dr
Lebanon, OH 45036-7929
Mailing address
439 Lake Shore Dr
Lebanon, OH 45036-7929
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP.6144 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396828800000",
"number": "1417375494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "439 LAKE SHORE DR",
"city": "LEBANON",
"state": "OH",
"postal_code": "450367929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "439 LAKE SHORE DR",
"city": "LEBANON",
"state": "OH",
"postal_code": "450367929",
"telephone_number": "513-228-0025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMICHELE",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-07",
"last_updated": "2014-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.6144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.