Individual provider Active NPI

Kimberly Pajor-Perrin, M.S. CCC SP

  • Speech-Language Pathologist
  • Naples, ME
National Provider Identifier
1609933779
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1705 Issued in ME
Practice address
81 Madison Dr
Naples, ME 04055-5039
Phone
(207) 402-1130
NPI assigned
Jan 1, 2007
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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 SP1705 ME Primary

Addresses

Primary practice location

81 Madison Dr
Naples, ME 04055-5039

Mailing address

81 Madison Dr
Naples, ME 04055-5039
Phone (207) 402-1130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210224002026 ME Practitioner - Qualified Speech Language Pathologist 9537206578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1890NMMDPeer Specialist
SP1705MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Your Horizons Speech Therapy Speech-Language Pathologist CurrentSince Feb 2, 2021 Accepting new patients

Organizations & group practices 1

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": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1609933779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MADISON DR",
            "city": "NAPLES",
            "state": "ME",
            "postal_code": "040555039",
            "telephone_number": "207-402-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MADISON DR",
            "city": "NAPLES",
            "state": "ME",
            "postal_code": "040555039",
            "telephone_number": "207-402-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJOR-PERRIN",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP1705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.