Individual provider Active NPI

Kimberly Sue McNeill, SLP

  • Speech-Language Pathologist
  • Saint Charles, MO
National Provider Identifier
1497809073
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2006015399 Issued in MO
Practice address
912 Lafayette Landing PL
Saint Charles, MO 63303-1742
Phone
(314) 324-3330
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2006015399 MO Primary

Addresses

Primary practice location

912 Lafayette Landing PL
Saint Charles, MO 63303-1742

Mailing address

912 Lafayette Landing PL
Saint Charles, MO 63303-1742
Phone (314) 324-3330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416002631 MO Practitioner - Qualified Speech Language Pathologist 2466891007 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006015399MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc. Speech-Language Pathologist CurrentSince Mar 25, 2024 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Mar 25, 2024 Accepting new patients

Locations

15950 Manchester Rd
Ellisville, MO 63011
Phone (636) 220-2748

7920 Clayton Rd
Saint Louis, MO 63117
Phone (314) 226-9614

110 Horizon Dr
#310
Raleigh, NC 27615

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497809073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 LAFAYETTE LANDING PL",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633031742",
            "telephone_number": "314-324-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 LAFAYETTE LANDING PL",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633031742",
            "telephone_number": "314-324-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEILL",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2006015399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.