Active NPI
Kimberly M Segrest, MS CCC-SLP
- Speech-Language Pathologist
- Lewisville, TX
National Provider Identifier
1457015778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 19082
- Practice address
- 8798 Scottys Lake LN
Lewisville, TX 75056-6830 - Phone
- (972) 947-9463
- NPI assigned
- Oct 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 19082 | TX | Primary |
Addresses
Primary practice location
8798 Scottys Lake LN
Lewisville, TX 75056-6830
Mailing address
124 Pennsylvania Dr
Denton, TX 76205-5462
Phone (940) 453-4242
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19082 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634860800000",
"number": "1457015778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 PENNSYLVANIA DR",
"city": "DENTON",
"state": "TX",
"postal_code": "762055462",
"telephone_number": "940-453-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8798 SCOTTYS LAKE LN",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750566830",
"telephone_number": "972-947-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEGREST",
"first_name": "KIMBERLY",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-22",
"last_updated": "2021-10-22",
"certification_date": "2021-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "19082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.