Kirsten Cameron Mains, MA, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22003108A Issued in IN

Practice address

1481 W 10TH St
Indianapolis, IN 46202-2803

Phone

(317) 988-2613

NPI assigned

Dec 23, 2009

Last updated

Aug 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kirsten Cameron Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1457680316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINS",
        "first_name": "KIRSTEN",
        "middle_name": "CAMERON",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-23",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22003108A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "JOHNSON",
            "middle_name": "CAMERON",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.