Active NPI
Kristi K Kinnard, MA CCC SLP
- Speech-Language Pathologist
- Athens, OH
National Provider Identifier
1497820286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP2990
- Practice address
- W174 Grover Center
Ohio University Therapy Assoc
Athens, OH 45701 - Phone
- (740) 593-1404
- Fax
- (740) 593-4433
- NPI assigned
- Nov 21, 2006
- 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 | SP2990 | OH | Primary |
Addresses
Primary practice location
W174 Grover Center
Ohio University Therapy Assoc
Athens, OH 45701
Mailing address
W174 Grover Center
Athens, OH 45701
Phone (740) 593-1404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000246469 | Other | OH | ANTHEM GRP # |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP2990 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1497820286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W174 GROVER CENTER",
"city": "ATHENS",
"state": "OH",
"postal_code": "45701",
"telephone_number": "740-593-1404",
"fax_number": "740-593-4433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W174 GROVER CENTER",
"address_2": "OHIO UNIVERSITY THERAPY ASSOC",
"city": "ATHENS",
"state": "OH",
"postal_code": "45701",
"telephone_number": "740-593-1404",
"fax_number": "740-593-4433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNARD",
"first_name": "KRISTI",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "MA CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP2990",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM GRP #",
"identifier": "000000246469",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.