Active NPI
Jessica Sohl Kimball, CCC-SLP
- Speech-Language Pathologist
- Lunenburg, MA
National Provider Identifier
1659847457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 77007-SP-SL
- Practice address
- 24 Massachusetts Ave
Lunenburg, MA 01462-1273 - Phone
- (978) 833-1887
- Fax
- (978) 252-5218
- NPI assigned
- Oct 18, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 77007-SP-SL | MA | Primary |
Addresses
Primary practice location
24 Massachusetts Ave
Lunenburg, MA 01462-1273
Mailing address
33 Ann Lee Rd
Harvard, MA 01451-1217
Phone (734) 417-6462
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 |
|---|---|---|---|
| 77007-SP-SL | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539820800000",
"number": "1659847457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 ANN LEE RD",
"city": "HARVARD",
"state": "MA",
"postal_code": "014511217",
"telephone_number": "734-417-6462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 MASSACHUSETTS AVE",
"city": "LUNENBURG",
"state": "MA",
"postal_code": "014621273",
"telephone_number": "978-833-1887",
"fax_number": "978-252-5218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "JESSICA",
"middle_name": "SOHL",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-18",
"last_updated": "2018-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "77007-SP-SL",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lunenburg, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.