Active NPI
Kimberly Anne Stewart, CCC-SLP
- Speech-Language Pathologist
- Ponchatoula, LA
National Provider Identifier
1811044068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3432
- Practice address
- 132 South 6TH Street
Ponchatoula, LA 70454 - Phone
- (985) 969-0517
- Fax
- (985) 718-1878
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3432 | LA | Primary |
Addresses
Primary practice location
132 South 6TH Street
Ponchatoula, LA 70454
Mailing address
3266 Range CT
Mandeville, LA 70448-8494
Phone (985) 237-4944
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3432 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ponchatoula Therapy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Ponchatoula, LA
- NPI 1922398544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304467200000",
"number": "1811044068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3266 RANGE CT",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704488494",
"telephone_number": "985-237-4944",
"fax_number": "985-718-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 SOUTH 6TH STREET",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "70454",
"telephone_number": "985-969-0517",
"fax_number": "985-718-1878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"name_prefix": "Prof.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2011-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "3432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.