NPIMap

Organization Active NPI

Kidcom, L.L.C.

  • Speech-Language Pathologist
  • Clayton, NC
National Provider Identifier
1740333731
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
09144065 Issued in NC
Legal business name
KIDCOM, L.L.C.
Practice address
865 Carlton St
Clayton, NC 27520-3716
Phone
(919) 550-2457
Fax
(919) 585-4603
NPI assigned
Jan 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tina Marie Pope, CCC-SLPNPI 1982705489
Title
President
Phone
(919) 550-2457

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 09144065 NC Primary

Addresses

Primary practice location

865 Carlton St
Clayton, NC 27520-3716

Mailing address

865 Carlton St
Clayton, NC 27520-3716
Phone (919) 550-2457

Other identifiers 1

IdentifierTypeStateIssuer
7411774MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740333731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 CARLTON ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275203716",
            "telephone_number": "919-550-2457",
            "fax_number": "919-585-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 CARLTON ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275203716",
            "telephone_number": "919-550-2457",
            "fax_number": "919-585-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDCOM, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-550-2457",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "09144065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411774",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.