Active NPI
Kimberly Hodge
- Speech-Language Pathologist
- Miami Gardens, FL
National Provider Identifier
1659906063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15793
- Practice address
- 5725 NW 186TH St
Miami Gardens, FL 33015-6019 - Phone
- (305) 625-9857
- NPI assigned
- Mar 5, 2020
- 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 | 15793 | FL | Primary |
Addresses
Primary practice location
5725 NW 186TH St
Miami Gardens, FL 33015-6019
Mailing address
655 S Willow St Ste 128655S
Manchester, NH 03103-5714
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 |
|---|---|---|---|
| 15793 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583366400000",
"number": "1659906063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 S WILLOW ST STE 128655S",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031035714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5725 NW 186TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330156019",
"telephone_number": "305-625-9857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-05",
"last_updated": "2020-03-05",
"certification_date": "2020-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "15793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.