KIMBERLY LYNN KENNEMORE — NPI 1306622659 (Licensed & Credentialed Specialist/Technologist, Speech-Language Assistant in ASHDOWN, AR)

CMS-1500 Box 24J / 33a • NPI

1306622659

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2355S0801X

Licensed & Credentialed Specialist/Technologist, Speech-Language Assistant

Box 32 Service Location & ZIP+4

410 BURKE ST, ASHDOWN, AR, 71822-2908

✓ 9-Digit EDI 837 ZIP+4 (71822-2908)

Practice Phone & Referral Fax

(903) 278-7709

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1306622659 (KIMBERLY LYNN KENNEMORE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1306622659` (NPI-1 Individual Practitioner)
Provider / Legal Name	KIMBERLY LYNN KENNEMORE
Plain-English Specialty	Licensed & Credentialed Specialist/Technologist, Speech-Language Assistant NUCC Code: `2355S0801X` (Specialist/Technologist, Speech-Language Assistant)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	410 BURKE ST, ASHDOWN, AR, 71822-2908
Practice Telephone / Fax	Tel: (903) 278-7709
Administrative Mailing Address	420 LR 17, ASHDOWN, AR, 71822-9451
Enumeration & Last Sync	Enumerated: 2023-09-04 \| CMS Record Updated: 2023-09-04

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

410 BURKE ST, ASHDOWN, AR, 71822-2908

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Plain-English Taxonomy & CMS Crosswalk (2355S0801X)

What Does Taxonomy Code 2355S0801X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2355S0801X translates to:
"Licensed & Credentialed Specialist/Technologist, Speech-Language Assistant"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Specialist/Technologist, Speech-Language Assistant for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (KIMBERLY LYNN KENNEMORE)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2355S0801X` — Specialist/Technologist, Speech-Language Assistant Plain English: Licensed & Credentialed Specialist/Technologist, Speech-Language Assistant	State: AR \| License: `202434` \| Primary: Yes (Primary)

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KIMBERLY LYNN KENNEMORE (NPI #1306622659)