Active NPI
Ronald C. Kuebler, CCC-SLP, ABDA
- Speech-Language Pathologist
- Columbia, SC
National Provider Identifier
1629000435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 816
- Practice address
- 6601 Eastbrook Rd
Columbia, SC 29206-2207 - Phone
- (803) 429-6730
- Fax
- (803) 787-6889
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 816 | SC | Primary |
| Speech-Language Pathologist | 235Z00000X | 1669 | GA | |
| Speech-Language Pathologist | 235Z00000X | 6816 | NC |
Addresses
Primary practice location
6601 Eastbrook Rd
Columbia, SC 29206-2207
Mailing address
6601 Eastbrook Rd
Columbia, SC 29206-2207
Phone (803) 429-6730
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629000435 | Other | SC | MEDICARE PART B |
| GP4290 | Medicaid | SC | |
| 203658505 | Other | SC | TRICARE PROVIDER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6816 | NC | MD | Dentist |
| 1669 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366934400000",
"number": "1629000435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 EASTBROOK RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292062207",
"telephone_number": "803-429-6730",
"fax_number": "803-787-6889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 EASTBROOK RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292062207",
"telephone_number": "803-429-6730",
"fax_number": "803-787-6889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUEBLER",
"first_name": "RONALD",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "CCC-SLP, ABDA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2013-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "816",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "1669",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "6816",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "1629000435",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP4290",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE PROVIDER",
"identifier": "203658505",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.