MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) – Speech-Language Pathologist, NPI 1669956330

MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) is a healthcare provider. based in Uniontown, Ohio. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials M.S. , CCC-SLP. They hold a License No. SP.11095 (OH). The NPI Number for MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) is 1669956330

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP)
NPI
1669956330
Phone
(330) 595-9173
Address
3570 EXECUTIVE DR STE 208
Enumeration Date
19 September 2018
Last Update Date
19 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3305959059
Graduation Year
1998 (28 years ago)
PAC ID
8820332976
Group Practice PAC ID
4183913999
Professional Enrollment ID
I20181130001787
Address ID
OH446858078UN11330NWXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

312 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in OH

Provider Addresses for MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP)

  • 3570 EXECUTIVE DR STE 208

    UNIONTOWN, OH 446858712

    Phone: (330) 595-9173

    Fax: (330) 595-1525

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-11-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181130001787IQualified Speech Language PathologistOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44685)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183913999View full group profile
NameSpecialtyState
Mental Health CounselorOH
Qualified Speech Language PathologistOH
Qualified Speech Language PathologistOH

Reviews

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Frequently asked questions

Can I verify MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) with an NPI only?
You can start verification with NPI 1669956330 for MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP), then check state licensing separately.
Is MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) listed as active for patients and plans?
The listing shows MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) as active in the NPI system.
What taxonomy line describes MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP)?
For research purposes, treat MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) as Speech-Language Pathologist in this dataset. Clinical services aligned with this taxonomy classification.
Does MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) list a practice location?
Patients near Uniontown, Ohio may find MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) in results; validate coverage separately.
Why does MRS. AMANDA KRISTEN KIM (M.S. , CCC-SLP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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