Active NPI
Kimberly Gates
- Speech-Language Pathologist
- Royal Center, IN
National Provider Identifier
1609288232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22005086A
- Practice address
- 5872 W State Road 16
Royal Center, IN 46978-9028 - Phone
- (574) 721-1010
- NPI assigned
- Jun 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 22005086A | IN | Primary |
Addresses
Primary practice location
5872 W State Road 16
Royal Center, IN 46978-9028
Mailing address
5872 W State Road 16
Royal Center, IN 46978-9028
Phone (574) 721-1010
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22005086A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1609288232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5872 W STATE ROAD 16",
"city": "ROYAL CENTER",
"state": "IN",
"postal_code": "469789028",
"telephone_number": "574-721-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5872 W STATE ROAD 16",
"city": "ROYAL CENTER",
"state": "IN",
"postal_code": "469789028",
"telephone_number": "574-721-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-02",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22005086A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royal Center, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.