Individual provider Active NPI

Kimberly Michelle Schifano, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Fort Mill, SC
National Provider Identifier
1902209836
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4449 Issued in SC
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, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180501000678 SC Practitioner - Qualified Speech Language Pathologist 8820352735 Reassigns benefits to 1 organization
I20190218002928 NC Practitioner - Qualified Speech Language Pathologist 8820352735 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
12850NCMDDentist
4449SCMDGeneral Practice Dentistry
10948NCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Threshold Therapeutic, LLC Speech-Language Pathologist CurrentSince Jul 2, 2021 Accepting new patients
Carolina Speech Works, LLC Speech-Language Pathologist CurrentSince Mar 8, 2018 Accepting new patients

Locations

975 Market St
Ste 201D
Fort Mill, SC 29708
Phone (317) 694-6533

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.