Individual provider Active NPI

Kim Levenson

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1598188534
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ6525 Issued in FL
Practice address
1128 N Laura St
Jacksonville, FL 32206-4912
Phone
(904) 355-3403
Fax
(904) 355-4919
NPI assigned
Jan 28, 2014
Last updated
Jan 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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 SZ6525 FL Primary

Addresses

Primary practice location

1128 N Laura St
Jacksonville, FL 32206-4912

Mailing address

1128 N Laura St
Jacksonville, FL 32206-4912
Phone (904) 355-3403

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

State licenses

LicenseStateTypeSpecialty
SZ6525FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cholla Medical Group, Inc PastSince Dec 15, 2006 Accepting new patients
Piller Child Development LLC Speech-Language Pathologist PastSince Nov 1, 2017 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1598188534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064912",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064912",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENSON",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ6525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.