Individual provider Active NPI

Kimberly Klooster-Penca, SLP

  • Speech-Language Pathologist
  • Clinton, IA
National Provider Identifier
1871723148
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
001923 Issued in IA
Practice address
1377 11TH St NW
Clinton, IA 52732-5068
Phone
(563) 241-4230
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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 001923 IA Primary

Addresses

Primary practice location

1377 11TH St NW
Clinton, IA 52732-5068

Mailing address

1377 11TH St NW
Clinton, IA 52732-5068
Phone (563) 241-4230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090904000213 IA Practitioner - Qualified Speech Language Pathologist 3870648330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Rehab IncorporatedGroup PAC ID 0840289633, 6 clinicians

Practice addresses (Care Compare)

1377 11TH St NW
Clinton, IA 52732-5068
Phone (563) 241-4230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1871723148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 11TH ST NW",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325068",
            "telephone_number": "563-241-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 11TH ST NW",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325068",
            "telephone_number": "563-241-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOSTER-PENCA",
        "first_name": "KIMBERLY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "001923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.