Kimberly Traci Dever, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6115 Issued in FL

Practice address

1104 Beville Rd Ste J
Daytona Beach, FL 32114-5765

Phone

(386) 252-7837

Fax

(386) 252-0021

NPI assigned

May 24, 2011

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

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.

• First Step Therapeutics

  • Pediatric Rehabilitation Medicine Physician
  • Daytona Beach, FL
  • NPI 1497884399
  NPD (past)

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1982997045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 BEVILLE RD STE J",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145765",
            "telephone_number": "386-252-7837",
            "fax_number": "386-252-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 BEVILLE RD STE J",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145765",
            "telephone_number": "386-252-7837",
            "fax_number": "386-252-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVER",
        "first_name": "KIMBERLY",
        "middle_name": "TRACI",
        "credential": "CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sureskumar D Desai, MD
• Utpal S Desai, M.D.
• Erik Desimone, R.PH.
• Alisha Dessavre, MD
• Ellen M Dethloff, NP
• Ruby Anne Deveras, MD
• Jane A Devine, LMFT
• Patricia A. Dewees, LMFT
• Olivia Mangat Dhaliwal, MD
• Preanka Dhanoa, MD

• Speech-Language Pathologist in Daytona Beach, FL
• Providers in Daytona Beach, 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 May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.