Active NPI
Kimberly Michelle Schifano, M.A., CCC-SLP
- Speech-Language Pathologist
- Fort Mill, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4449
- Practice address
- 975 Market St Ste 201D
Fort Mill, SC 29708-6531 - Phone
- (803) 339-3630
- Fax
- (803) 281-8877
- NPI assigned
- Oct 6, 2014
- Last updated
- Nov 19, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4449 | SC | Primary |
| Speech-Language Pathologist | 235Z00000X | 10948 | NC |
Addresses
Primary practice location
975 Market St Ste 201D
Fort Mill, SC 29708-6531
Mailing address
1218 Edbrooke LN
Fort Mill, SC 29715-0049
Phone (803) 339-3630
Other practice location 1
1218 Edbrooke Ln
Fort Mill, SC 29715-0049
Phone (803) 339-3630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, NC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Indiana University School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
317 Holdsworth Dr
Mount Holly, NC 28120-8711
Phone (317) 694-6533
975 Market St
Suite 201D
Fort Mill, SC 29708-6531
Phone (317) 694-6533
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12850 | NC | MD | Dentist |
| 4449 | SC | MD | General Practice Dentistry |
| 10948 | NC | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Threshold Therapeutic, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Carolina Speech Works, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
975 Market St
Ste 201D
Fort Mill, SC 29708
Phone (317) 694-6533
Interoperability endpoints
- https://api.platform.athenahealth.com/25089/brand/1/csg/1/fhir/r4
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Occupational Therapist
- Charlotte, NC
- NPI 1689299166
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1902209836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 EDBROOKE LN",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297150049",
"telephone_number": "803-339-3630",
"fax_number": "803-281-8877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 MARKET ST STE 201D",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297086531",
"telephone_number": "803-339-3630",
"fax_number": "803-281-8877"
}
],
"practiceLocations": [
{
"address_1": "1218 Edbrooke Ln",
"address_purpose": "LOCATION",
"city": "Fort Mill",
"state": "SC",
"postal_code": "297150049",
"country_code": "US",
"telephone_number": "803-339-3630",
"fax_number": "803-281-8877",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCHIFANO",
"first_name": "KIMBERLY",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-06",
"last_updated": "2021-11-19",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "4449",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "10948",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.