Individual provider Active NPI

Kim Scott Havard, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Hattiesburg, MS
National Provider Identifier
1598911331
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S0970 Issued in MS
Practice address
31 Tedington
Hattiesburg, MS 39402-7790
Phone
(601) 408-1365
Fax
(601) 450-2521
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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 S0970 MS Primary

Addresses

Primary practice location

31 Tedington
Hattiesburg, MS 39402-7790

Mailing address

31 Tedington
Hattiesburg, MS 39402-7790
Phone (601) 408-1365

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 Science

State licenses

LicenseStateTypeSpecialty
S0970MSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1598911331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 TEDINGTON",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027790",
            "telephone_number": "601-408-1365",
            "fax_number": "601-450-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 TEDINGTON",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027790",
            "telephone_number": "601-408-1365",
            "fax_number": "601-450-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVARD",
        "first_name": "KIM",
        "middle_name": "SCOTT",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S0970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.