Kimberly Benton, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2009015713 Issued in MO

Practice address

2202 S Main St
Grove, OK 74344-5328

Phone

(918) 964-7025

Fax

(918) 964-7024

NPI assigned

Oct 20, 2009

Last updated

Dec 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• The Wellness Co., PLLC

  • Speech-Language Pathologist
  • Grove, OK
  • NPI 1215336839
  Medicare reassignment NPD
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1780910182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S NORTHPARK LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648018426",
            "telephone_number": "417-623-4313",
            "fax_number": "417-621-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S MAIN ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743445328",
            "telephone_number": "918-964-7025",
            "fax_number": "918-964-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Northpark Ln",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648018426",
            "country_code": "US",
            "telephone_number": "417-623-4313 x11118",
            "fax_number": "417-621-0129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTON",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2009015713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Ann Barton, MD
• Brittany Ann Bascue, ANMT
• Bernardine Kay Baxter, COTA
• Zachary T Bechtol, MD
• James Stephen Beck
• Kathie A Bergmann
• Elizabeth Ann Bernardy, CM II
• Shealyn Berry, CNP
• Betty Ann Nursing Center LLC
• Beverly a Helms (Grand Prosthetics and Orthotics LightWeight Artificial Limbs Braces)

• Speech-Language Pathologist in Grove, OK
• Providers in Grove, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.