Individual provider Active NPI

Kimberly K Hollahan, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Nashville, TN
National Provider Identifier
1710116025
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 0000002696 Issued in TN
Practice address
311 23Rd Ave N
RM. 119
Nashville, TN 37203-1503
Phone
(615) 340-5697
Fax
(615) 340-7789
NPI assigned
Jul 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 0000002696 TN Primary

Addresses

Primary practice location

311 23Rd Ave N
RM. 119
Nashville, TN 37203-1503

Mailing address

311 23Rd Ave N
RM. 119
Nashville, TN 37203-1503
Phone (615) 340-5697

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 Arts

State licenses

LicenseStateTypeSpecialty
SP 0000002696TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1710116025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 23RD AVE N",
            "address_2": "RM. 119",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031503",
            "telephone_number": "615-340-5697",
            "fax_number": "615-340-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 23RD AVE N",
            "address_2": "RM. 119",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031503",
            "telephone_number": "615-340-5697",
            "fax_number": "615-340-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAHAN",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP 0000002696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.