Individual provider Active NPI

Kevin P Lemons, MS CCC SCP

  • Speech-Language Pathologist
  • Gilbert, AZ
National Provider Identifier
1548320393
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1006 Issued in AZ
Practice address
690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055
Phone
(480) 820-6366
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 1006 AZ Primary

Addresses

Primary practice location

690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055

Mailing address

690 E Warner Rd Ste 105
Gilbert, AZ 85296-3055
Phone (480) 820-6366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222002630 AZ Practitioner - Qualified Speech Language Pathologist 6204137995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mentis Reo, LLC.Group PAC ID 9739579715, 2 clinicians

Practice addresses (Care Compare)

690 E Warner Rd
Suite 105
Gilbert, AZ 85296-3055
Phone (480) 820-6366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1006AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mentis Reo, LLC. CurrentSince Aug 24, 2022 Accepting new patients
East Valley Speech Pathology Assoc LLC Past Accepting new patients

Locations

1783 E Queen Creek Rd
Ste 1
Chandler, AZ 85286
Phone (480) 820-6366

690 E Warner Rd
Ste 105
Gilbert, AZ 85296
Phone (480) 820-6366

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1548320393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963055",
            "telephone_number": "480-820-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E WARNER RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963055",
            "telephone_number": "480-820-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMONS",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "MS CCC SCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "1006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.