Individual provider Active NPI

Kimberly Huggins Hamilton, MS CCC-SLP

  • Speech-Language Pathologist
  • Ponte Vedra Beach, FL
National Provider Identifier
1417911520
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA Issued in FL
Practice address
114 Bay Hill CT
Ponte Vedra Beach, FL 32082-3602
Phone
(904) 439-3032
NPI assigned
Apr 14, 2006
Last updated
Aug 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 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 SA FL Primary

Addresses

Primary practice location

114 Bay Hill CT
Ponte Vedra Beach, FL 32082-3602

Mailing address

114 Bay Hill CT
Ponte Vedra Beach, FL 32082-3602
Phone (904) 439-3032

Other practice location 1

151 Creekside Dr
St Augustine, FL 32086-5406
Phone (256) 996-9789

Other practice location 2

1000 W Broadway St Ste 214
Oviedo, FL 32765-9262
Phone (407) 359-5693

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SAFLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Madhatters LLC Speech-Language Pathologist CurrentSince Apr 6, 2021 Accepting new patients

Organizations & group practices 1

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1417911520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BAY HILL CT",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823602",
            "telephone_number": "904-439-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BAY HILL CT",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823602",
            "telephone_number": "904-439-3032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Creekside Dr",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865406",
            "country_code": "US",
            "telephone_number": "256-996-9789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W Broadway St Ste 214",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327659262",
            "country_code": "US",
            "telephone_number": "407-359-5693",
            "fax_number": "407-792-5693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KIMBERLY",
        "middle_name": "HUGGINS",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.