Individual provider Active NPI

Kirby Coffey

  • Speech-Language Assistant
  • Charleston, SC
National Provider Identifier
1619656295
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
7042 Issued in SC
Practice address
1563 Sam Rittenberg Blvd
Charleston, SC 29407-4248
Phone
(843) 277-2411
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 7042 SC Primary

Addresses

Primary practice location

1563 Sam Rittenberg Blvd
Charleston, SC 29407-4248

Mailing address

1563 Sam Rittenberg Blvd
Charleston, SC 29407-4248

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
7042SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston OT LLC CurrentSince Jan 28, 2024 Accepting new patients
Charleston St LLC CurrentSince Jul 16, 2023 Accepting new patients

Locations

1563 Sam Rittenbrg Blvd
Charleston, SC 29407
Phone (843) 277-2411

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1619656295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 SAM RITTENBERG BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 SAM RITTENBERG BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074248",
            "telephone_number": "843-277-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "KIRBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "SC",
            "license": "7042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.