Taylor Kimbrough, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146010537 Issued in IL

Practice address

10733 Revere Rd
Mokena, IL 60448-1903

Phone

(708) 837-8869

Fax

(708) 694-7006

NPI assigned

Aug 17, 2011

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

Other identifiers 1

Other names 1

• Taylor Bussie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Thrive Kids Speech Therapy

  • Speech-Language Pathologist
  • Mokena, IL
  • NPI 1245122209
  NPD Authorized official
• Thrive Kids Speech Therapy LLC

  • Speech-Language Pathologist
  • Mokena, IL
  • NPI 1215888193
  NPD Authorized official

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1821378266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10733 REVERE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481903",
            "telephone_number": "708-837-8869",
            "fax_number": "708-694-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10733 REVERE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481903",
            "telephone_number": "708-837-8869",
            "fax_number": "708-694-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "TAYLOR",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146010537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09932114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "BUSSIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Kenny, APRN, FNP-C, ENP-C
• Kid'S First Words, LLC
• Kids Can DO Inc.
• Kids Can DO, Inc.
• Libby Jane Killelea
• Kindness Institute, LLC
• Rebecca Kingma, PHARM.D.
• Lindsay Kiszkowski, M.S. CCC-SLP/L
• Marijo Kay Kleinfelder, OTRL
• Jenna Kristina Klich, COTA/L

• Speech-Language Pathologist in Mokena, IL
• Providers in Mokena, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.