Individual provider Active NPI

Kimberly Murphy Pegg, MS

  • Speech-Language Pathologist
  • Beverly, MA
National Provider Identifier
1790383859
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
100 Cummings Ctr Ste 135H
Beverly, MA 01915-6127
Phone
(978) 927-0172
NPI assigned
Oct 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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 Primary

Addresses

Primary practice location

100 Cummings Ctr Ste 135H
Beverly, MA 01915-6127

Mailing address

100 Cummings Ctr Ste 135H
Beverly, MA 01915-6127
Phone (978) 927-0172

Other practice location 1

30 Colby Ct
Bedford, NH 03110-6426
Phone (602) 625-6264

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://access.genesishcc.com/,DanaInfo=genstarlite.genesishcc.com,SSL,SSO=U+ Direct Bedford Hills Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227000399 MA Practitioner - Qualified Speech Language Pathologist 1153712393 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Lark and Lantern Therapies, LLC Speech-Language Pathologist Current Accepting new patients
Speech Therapy Group, LLC. Speech-Language Pathologist CurrentSince Dec 1, 2021 Accepting new patients
The Verbal ABA Clinic, LLC PastSince Dec 1, 2021 Accepting new patients

Locations

100 Cummings Ctr
Ste 135H
Beverly, MA 01915
Phone (978) 927-0172

Organizations & group practices 3

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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1790383859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 135H",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156127",
            "telephone_number": "978-927-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 135H",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156127",
            "telephone_number": "978-927-0172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Colby Ct",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106426",
            "country_code": "US",
            "telephone_number": "602-625-6264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEGG",
        "first_name": "KIMBERLY",
        "middle_name": "MURPHY",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://access.genesishcc.com/,DanaInfo=genstarlite.genesishcc.com,SSL,SSO=U+",
            "affiliation": "Y",
            "endpointDescription": "Secure Messaging",
            "affiliationName": "Bedford Hills Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 Colby Ct",
            "city": "Bedford",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031106426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.