Individual provider Active NPI

Kim Earnhart

  • Speech-Language Pathologist
  • Scottsdale, AZ
National Provider Identifier
1891156881
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
10049 E Dynamite Blvd Ste 110
Scottsdale, AZ 85262-3694
Phone
(480) 419-0848
NPI assigned
Mar 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

10049 E Dynamite Blvd Ste 110
Scottsdale, AZ 85262-3694

Mailing address

PO Box 10869 N. Scottsdale Rd. #103-112
Scottsdale, AZ 85260-4740
Phone (480) 425-0339

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamite Therapy, LLC CurrentSince Aug 2, 2020 Accepting new patients

Locations

10049 E Dynamite Blvd
Ste 110
Scottsdale, AZ 85262
Phone (480) 419-0848

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": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1891156881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10869 N. SCOTTSDALE RD. #103-112",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604740",
            "telephone_number": "480-425-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10049 E DYNAMITE BLVD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852623694",
            "telephone_number": "480-419-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARNHART",
        "first_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.