Individual provider Active NPI

Kristin A Macinnis

  • Speech-Language Pathologist
  • Dover, NH
National Provider Identifier
1780939827
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1427 Issued in NH
Practice address
750 Central Ave
Suite C
Dover, NH 03820-3434
Phone
(603) 926-3277
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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 1427 NH Primary

Addresses

Primary practice location

750 Central Ave
Suite C
Dover, NH 03820-3434

Mailing address

23 Wentworth Rd
Berwick, ME 03901-2831
Phone (603) 548-6661

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

State licenses

LicenseStateTypeSpecialty
1427NHMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Speak Easy New England LLC CurrentSince Dec 18, 2022 Accepting new patients
Clearly Speaking LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1780939827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WENTWORTH RD",
            "city": "BERWICK",
            "state": "ME",
            "postal_code": "039012831",
            "telephone_number": "603-548-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 CENTRAL AVE",
            "address_2": "SUITE C",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203434",
            "telephone_number": "603-926-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINNIS",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "1427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.