Individual provider Active NPI

Kimberly D Durham, CCC-SLP

  • Speech-Language Pathologist
  • Pittsburgh, PA
National Provider Identifier
1972803492
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL009006 Issued in PA
Practice address
100 S Jackson Ave
Pittsburgh, PA 15202-3428
Phone
(412) 734-6030
Fax
(412) 734-6881
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 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 SL009006 PA Primary

Addresses

Primary practice location

100 S Jackson Ave
Pittsburgh, PA 15202-3428

Mailing address

100 S Jackson Ave
Pittsburgh, PA 15202-3428
Phone (412) 734-6030

Other identifiers 1

IdentifierTypeStateIssuer
102530724MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdurham71466@direct.ahn.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110314000383 PA Practitioner - Qualified Speech Language Pathologist 7315129244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

100 S Jackson Ave
Pittsburgh, PA 15202-3428
Phone (412) 939-3090

62 Greenbriar Dr
Suite 1
Leechburg, PA 15656-8209
Phone (724) 845-7765

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SL009006PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Speech-Language Pathologist CurrentSince Nov 15, 2010 Accepting new patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Nov 15, 2010 Accepting new patients

Locations

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

100 S Jackson Ave
Pittsburgh, PA 15202
Phone (412) 734-6030

500 Blazier Dr
Ste 101
Wexford, PA 15090

Interoperability endpoints

  • Direct secure messaging: kdurham71466@direct.ahn.org

Organizations & group practices 6

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1972803492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S JACKSON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152023428",
            "telephone_number": "412-734-6030",
            "fax_number": "412-734-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JACKSON AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152023428",
            "telephone_number": "412-734-6030",
            "fax_number": "412-734-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102530724",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdurham71466@direct.ahn.org",
            "affiliation": "N",
            "address_1": "100 S Jackson Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152023428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.