Active NPI
Kimberly D Durham, CCC-SLP
- Speech-Language Pathologist
- Pittsburgh, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL009006
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102530724 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kdurham71466@direct.ahn.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Clinic
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 100
- Quality
- 85.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL009006 | PA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allegheny Clinic | Speech-Language Pathologist | Current | Accepting new patients |
| Allegheny Clinic | Current | Accepting new patients | |
| Allegheny Clinic | Current | 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
- 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.
-
- Radiation Oncology Physician
- Pittsburgh, PA
- NPI 1114927530
-
- Ambulatory Surgical Clinic/Center
- Wexford, PA
- NPI 1124439450
-
- Community/Retail Pharmacy
- Wexford, PA
- NPI 1427451764
-
- Primary Care Clinic/Center
- Pittsburgh, PA
- NPI 1215752548
-
- Speech-Language Pathologist
- MC Murray, PA
- NPI 1265845044
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.