Individual provider Active NPI

Kylie Jester

  • Speech-Language Pathologist
  • Mount Pleasant, SC
National Provider Identifier
1417596826
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1051 Johnnie Dodds Blvd
Mount Pleasant, SC 29464-3100
Phone
(843) 654-9694
NPI assigned
Jan 2, 2020
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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 NU Primary

Addresses

Primary practice location

1051 Johnnie Dodds Blvd
Mount Pleasant, SC 29464-3100

Mailing address

3217 Seaborn Dr
Mount Pleasant, SC 29466-8529
Phone (843) 300-2812

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Pleasant Pediatric Physical Therapy, LLC PastSince Jan 5, 2020 Accepting new patients
Mt. Pleasant Pediatric Speech Therapy, LLC Speech-Language Pathologist PastSince Jan 5, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1417596826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 SEABORN DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294668529",
            "telephone_number": "843-300-2812",
            "fax_number": "843-480-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 JOHNNIE DODDS BLVD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643100",
            "telephone_number": "843-654-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESTER",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.