Active NPI
Kimberly Thomas, MS-SLP
- Speech-Language Pathologist
- Issaquah, WA
National Provider Identifier
1497138077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- LL60348840
- Practice address
- 805 Front St S
Issaquah, WA 98027-4205 - Phone
- (425) 392-1271
- NPI assigned
- Jul 1, 2015
- 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 | LL60348840 | WA | Primary |
Addresses
Primary practice location
805 Front St S
Issaquah, WA 98027-4205
Mailing address
805 Front St S
Issaquah, WA 98027-4205
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL60348840 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independence Rehab, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
5314 N River Run Dr
Ste 140
Provo, UT 84604
Phone (801) 471-2449
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1497138077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 FRONT ST S",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980274205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 FRONT ST S",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980274205",
"telephone_number": "425-392-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "KIMBERLY",
"credential": "MS-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-01",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "LL60348840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.