Kimberly Pettis, M.S.CCC-SLP
NPI 1689739914 · Speech-Language Pathologist · Port Jefferson, NY
Kimberly Pettis, M.S.CCC-SLP is a Speech-Language Pathologist provider in Port Jefferson, NY (NPI 1689739914).
Provider details
- NPI number
- 1689739914
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- M.S.CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- License
- 012235-1 (NY)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-12-27
- Last updated
- 2007-07-08
Frequently asked questions
- What is Kimberly Pettis's NPI number?
- Kimberly Pettis's National Provider Identifier (NPI) is 1689739914, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kimberly Pettis's specialty?
- Kimberly Pettis is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist (Speech, Language and Hearing Service Providers).
- Where is Kimberly Pettis located?
- Kimberly Pettis's practice location on file with NPPES is 200 Belle Terre Rd, Port Jefferson, NY 11777-1928.
- What is Kimberly Pettis's phone number?
- The practice phone number listed in the NPPES registry for Kimberly Pettis is (631) 474-6263.
- Is Kimberly Pettis's NPI active?
- Yes — Kimberly Pettis's NPI (1689739914) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.