1306919477 NPI number — KIMBERLY LYNN LAPIDUS M.S., CCC-SLP

Table of content: KIMBERLY LYNN LAPIDUS M.S., CCC-SLP (NPI 1306919477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306919477 NPI number — KIMBERLY LYNN LAPIDUS M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAPIDUS
Provider First Name:
KIMBERLY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAPIDUS
Provider Other First Name:
KIM
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC-SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306919477
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
718 BRESSLYN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37205-2602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-352-9096
Provider Business Mailing Address Fax Number:
615-352-9096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
718 BRESSLYN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37205-2602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-352-9096
Provider Business Practice Location Address Fax Number:
615-352-9096
Provider Enumeration Date:
11/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  0000003082 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5441017 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4125244 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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