Kimberly Breedlove, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.11702 Issued in OH

Practice address

450 Walnut St
Leetonia, OH 44431

Phone

(330) 427-2115

NPI assigned

Aug 14, 2014

Last updated

Jul 6, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Kerstetter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1689073694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 SHELBOURNE DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445113350",
            "telephone_number": "814-964-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WALNUT ST",
            "city": "LEETONIA",
            "state": "OH",
            "postal_code": "44431",
            "telephone_number": "330-427-2115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Plz",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445550001",
            "country_code": "US",
            "telephone_number": "330-941-1927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREEDLOVE",
        "first_name": "KIMBERLY",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KERSTETTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Connie M Benner
• Board of Education Leetonia
• Crystal Boso
• Miranda Clay
• David Andrew Conrad
• Carrie L Crawford, PCC-S
• Jamie Lee Davis, INDEPENDENT PROVIDER
• Raymond A Davis II

• Speech-Language Pathologist in Leetonia, OH
• Providers in Leetonia, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.

Verify at the official NPI Registry.