Active NPI
Regina Darlene Kinnard, MED.
- Speech-Language Pathologist
- Pontiac, MI
National Provider Identifier
1518255603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 106899
- Practice address
- 594 Alton Ave
Pontiac, MI 48341-2607 - Phone
- (248) 818-6638
- NPI assigned
- Jul 11, 2011
- 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 | 106899 | TX | Primary |
Addresses
Primary practice location
594 Alton Ave
Pontiac, MI 48341-2607
Mailing address
594 Alton Ave
Pontiac, MI 48341-2607
Phone (248) 818-6638
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106899 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310342400000",
"number": "1518255603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "594 ALTON AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412607",
"telephone_number": "248-818-6638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "594 ALTON AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412607",
"telephone_number": "248-818-6638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNARD",
"first_name": "REGINA",
"middle_name": "DARLENE",
"name_prefix": "Ms.",
"credential": "MED.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-11",
"last_updated": "2011-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "106899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.