MS. KRISTINA RENEE PEGRAM M.S.CCC-SLP
NPI 1215110275
Speech-Language Pathologist in Yorktown, VA

Active since December 13, 2007Accepts Medicare Assignment
3540 VICTORY BLVD, YORKTOWN, VA 23693(757) 776-0736(757) 776-0737 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 3, 2024, Jun 29, 2018 (2 updates tracked since 2018).

About Ms. Kristina Renee Pegram M.s.ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KRISTINA RENEE PEGRAM M.S.CCC-SLP (NPI 1215110275) is an individual speech-language pathologist provider in Yorktown, Virginia, licensed in Virginia (2202004684) and active in the NPI registry since December 2007. She maintains a secondary practice location in Heathrow and is a graduate of Other (2004).

NPPES Registry Identity

NPI1215110275
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMS. KRISTINA RENEE PEGRAMCredential: M.S.CCC-SLP
Location Address3540 VICTORY BLVDYorktown, VA 23693
Mailing Address3540 Victory BlvdYorktown, VA 23693-3641 · (757) 776-0736 · Fax (757) 776-0737
Fax(757) 776-0737
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateDecember 13, 2007
Last NPPES UpdateJuly 3, 20242 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
NPI 1215110275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License Licensed in VA · 2202004684
Definition

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Also ListedRehabilitation PractitionerTaxonomy 225400000X · License 2202004684 (VA)
3540 VICTORY BLVD, Yorktown, VA 23693

Secondary Practice Location 1

Location 11485 International PkwyHeathrow, FL 32746-5303 · Phone (800) 798-6035

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Kristina Renee Pegram M.s.ccc-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012228984
PECOS Enrollment IDI20150716001814

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
3540 VICTORY BLVD
YORKTOWN, VA 23693
Physical Therapy Assistant
3540 VICTORY BLVD
YORKTOWN, VA 23693
Physical Therapist
3540 VICTORY BLVD
YORKTOWN, VA 23693
Physical Therapy Assistant
3540 VICTORY BLVD
YORKTOWN, VA 23693
Occupational Therapist
3540 VICTORY BLVD
YORKTOWN, VA 23693
Occupational Therapist
3540 VICTORY BLVD
YORKTOWN, VA 23693

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215110275, enumerated as an "individual" on December 13, 2007.

The provider is located at 3540 VICTORY BLVD YORKTOWN, VA 23693 and the phone number is (757) 776-0736.

Speech-Language Pathologist with taxonomy code 235Z00000X.