Kimberly Kathlene Booth, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA3850 Issued in FL

Practice address

16102 N Florida Ave
Lutz, FL 33549-6129

Phone

(813) 873-1936

Fax

(813) 873-8837

NPI assigned

Sep 25, 2006

Last updated

Sep 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Therakids Plus Center for Children & Adults

  • Speech-Language Pathologist
  • Tampa, FL
  • NPI 1699923367
  Authorized official Same address or phone
• Therakids Plus, Inc.

  • Clinic/Center
  • Lutz, FL
  • NPI 1760583637
  Authorized official Same address or phone

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1932200805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16102 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496129",
            "telephone_number": "813-873-1936",
            "fax_number": "813-873-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16102 N FLORIDA AVE",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496129",
            "telephone_number": "813-873-1936",
            "fax_number": "813-873-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "KIMBERLY",
        "middle_name": "KATHLENE",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883512800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya R. Bogle, M.D.
• Peter R. Bolos, M.D.
• Gitendra Bommareddy, R.PH
• Terra Bone, LCSW
• Loicy Bonet I, BCBA-1-20-42842
• Karolina Borodo, MD
• Alycia Buford Boudreau, FNP-C
• Grace Anne Boudreau, MD
• Mary Bouie
• Adina Sara Boulos, DO

• Speech-Language Pathologist in Lutz, FL
• Providers in Lutz, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.