Active NPI
Kimberly Jedlicka, M.D.
- Family Medicine Physician
- Anchorage, AK
National Provider Identifier
1043641525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- TRN19208
- Practice address
- 4320 Diplomacy Dr
Suite 3121
Anchorage, AK 99508-5925 - Phone
- (907) 729-3361
- NPI assigned
- Dec 9, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | TRN19208 | FL | Primary |
Addresses
Primary practice location
4320 Diplomacy Dr
Suite 3121
Anchorage, AK 99508-5925
Mailing address
4320 Diplomacy Dr
Suite 3121
Anchorage, AK 99508-5925
Phone (907) 729-3361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN19208 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481068800000",
"number": "1043641525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4320 DIPLOMACY DR",
"address_2": "SUITE 3121",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085925",
"telephone_number": "907-729-3361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 DIPLOMACY DR",
"address_2": "SUITE 3121",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085925",
"telephone_number": "907-729-3361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDLICKA",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-09",
"last_updated": "2016-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "TRN19208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.