Active NPI
Kimberly Sue Luckring, MA CCC/SLP
- Speech-Language Pathologist
- Canton, OH
National Provider Identifier
1548689706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP-5323
- Practice address
- 3057 Cleveland Ave SW
Canton, OH 44707-3625 - Phone
- (330) 484-2547
- NPI assigned
- Apr 15, 2014
- 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 | SP-5323 | OH | Primary |
Addresses
Primary practice location
3057 Cleveland Ave SW
Canton, OH 44707-3625
Mailing address
2735 Duane Ave NW
Massillon, OH 44647
Phone (330) 904-4972
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP-5323 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397520000000",
"number": "1548689706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2735 DUANE AVE NW",
"city": "MASSILLON",
"state": "OH",
"postal_code": "44647",
"telephone_number": "330-904-4972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3057 CLEVELAND AVE SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447073625",
"telephone_number": "330-484-2547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKRING",
"first_name": "KIMBERLY",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "MA CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-15",
"last_updated": "2014-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP-5323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.