Active NPI
Kimberly Ann Boynton, MS CCC-SLP
- Speech-Language Pathologist
- Elkhart, IN
National Provider Identifier
1669695607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22003685A
- Practice address
- 810 W Bristol St Ste H
Elkhart, IN 46514-2954 - Phone
- (574) 266-0792
- Fax
- (574) 266-0927
- NPI assigned
- Apr 10, 2007
- 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 | 22003685A | IN | Primary |
Addresses
Primary practice location
810 W Bristol St Ste H
Elkhart, IN 46514-2954
Mailing address
1921 Peace Rose LN
Mishawaka, IN 46544-5892
Phone (574) 255-4120
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22003685A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669695607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 PEACE ROSE LN",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465445892",
"telephone_number": "574-255-4120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 W BRISTOL ST STE H",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142954",
"telephone_number": "574-266-0792",
"fax_number": "574-266-0927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYNTON",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22003685A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.