Kerry T Ridall, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL009285 Issued in PA

Practice address

400 East Second Street
Centennial Hall
Bloomsburg, PA 17815-1301

Phone

(570) 389-5380

Fax

(570) 389-5022

NPI assigned

Aug 26, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kerry T Cimino Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Husky Research Corporation Inc

  • Audiologist
  • Bloomsburg, PA
  • NPI 1518040179

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1548576713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1388",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187040388",
            "telephone_number": "570-683-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST SECOND STREET",
            "address_2": "CENTENNIAL HALL",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151301",
            "telephone_number": "570-389-5380",
            "fax_number": "570-389-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDALL",
        "first_name": "KERRY",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "CIMINO",
            "middle_name": "T",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Respiratory Support Systems, Inc. (Bloomsburg Medical Supply Inc)
• Audrey A Rich, MD
• Desiree Richards
• Evan Richardson
• Jamie E Rico
• Caroline Stephanie Riegel, CNM
• Erin Marie Riley
• Earl G. Ritter, D.C.
• Matthew J. Ritter, D.C.
• Samantha Roberts

• Speech-Language Pathologist in Bloomsburg, PA
• Providers in Bloomsburg, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.