Individual provider Active NPI

Kimberly Ann Wynns, M.ED., CCC/SLP

  • Speech-Language Pathologist
  • Durham, NC
National Provider Identifier
1588065437
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4089 Issued in NC
Practice address
146 Grey Elm TRL
Durham, NC 27713-7264
Phone
(919) 539-9409
NPI assigned
Sep 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 4089 NC Primary

Addresses

Primary practice location

146 Grey Elm TRL
Durham, NC 27713-7264

Mailing address

146 Grey Elm TRL
Durham, NC 27713-7264
Phone (919) 539-9409

Other practice location 1

808 Bacon St
Durham, NC 27703-5006
Phone (919) 560-2000

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

LicenseStateTypeSpecialty
4089NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1588065437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 GREY ELM TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137264",
            "telephone_number": "919-539-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 GREY ELM TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137264",
            "telephone_number": "919-539-9409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 Bacon St",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277035006",
            "country_code": "US",
            "telephone_number": "919-560-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNNS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.ED., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-10",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.