Active NPI
Kristin Smith McConnell, MS, CCC-SLP
- Speech-Language Pathologist
- Greenville, SC
National Provider Identifier
1700012358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4650
- Practice address
- 29 N Academy St
Greenville, SC 29601-2629 - Phone
- (864) 331-1400
- Fax
- (864) 331-1416
- NPI assigned
- Jun 9, 2009
- 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 | 4650 | SC | Primary |
Addresses
Primary practice location
29 N Academy St
Greenville, SC 29601-2629
Mailing address
3 Edge CT
Unit B
Greenville, SC 29609-5567
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 373282 | Medicaid | SC |
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 |
|---|---|---|---|
| 4650 | SC | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1700012358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 EDGE CT",
"address_2": "UNIT B",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296095567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 N ACADEMY ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012629",
"telephone_number": "864-331-1400",
"fax_number": "864-331-1416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "KRISTIN",
"middle_name": "SMITH",
"name_prefix": "Miss",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-09",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "4650",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "373282",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.