Kimberly Marie Gammon, MS-CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP010982 Issued in GA

Practice address

545 Old Norcross Rd Ste 200
Lawrenceville, GA 30046-3390

Phone

(678) 377-2833

NPI assigned

Apr 3, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Breezy Speech and Feeding, LLC

  • Speech-Language Pathologist
  • Lauderdale Lakes, FL
  • NPI 1306715008
  NPD Authorized official
• Sobe Innovative Rehabilitation PLLC

  • Physical Therapist
  • Miami, FL
  • NPI 1164800595
  Care Compare group

Specialty

Qualified Speech Language Pathologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sobe Innovative Rehabilitation PLLC 178 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1982233797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 ROSWELL RD UNIT 442",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283936",
            "telephone_number": "404-908-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 OLD NORCROSS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463390",
            "telephone_number": "678-377-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMON",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "MS-CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alpa M Gajjar, MS OT
• Hitesh C Gajjar
• Rachel Richman Gallen, D.O.
• Galon Consulting Services, LLC
• Kimberly Gamble, RN
• Shashank Vijay Gandhi, MD
• Malini Ganesh, MD
• Sreenivasulu R. Gangasani, MD
• Paige Gantt
• Lin Gao, MD

• All providers in Lawrenceville, GA
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.