Kimberly Dawn Mueller, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.017454 Issued in IL

Practice address

358 N 6TH St
Tecumseh, NE 68450-2297

Phone

(402) 335-3320

NPI assigned

Sep 15, 2015

Last updated

Apr 12, 2024By 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 2

Addresses

Other names 1

• Kimberly Dawn Ellicott Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Achieve Pediatric Therapy & Rehab PC

  • Pediatric Occupational Therapist
  • Cedar Park, TX
  • NPI 1205195070
  Medicare reassignment
• Johnson County Public Schools

  • School Psychologist
  • Tecumseh, NE
  • NPI 1083369599
  NPD (past)

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1730558289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 RIDGE LANE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215424",
            "telephone_number": "308-350-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 N 6TH ST",
            "city": "TECUMSEH",
            "state": "NE",
            "postal_code": "684502297",
            "telephone_number": "402-335-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.017454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "ELLICOTT",
            "middle_name": "DAWN",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mann & Mann Optometrists PC
• Gregory V Mann, O.D.
• Josiah McAllister, MD
• Sean L McClure, MSE, PLMHP
• Robert Timothy Morrissey, PHARM D
• Oakwood Alf Ventures, LLC
• Oakwood Ventures, LLC (Belle Terrace)
• Ashley A Rentas Roses
• Debi K Rinne
• Jayne Susanne Robbins

• Speech-Language Pathologist in Tecumseh, NE
• Providers in Tecumseh, NE by specialty
• Speech-Language Pathologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.