Kimberly Jane Paine, MED, CCS

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2201000309 Issued in VA

Practice address

2070 Old Bridge Rd
Suite 103
Woodbridge, VA 22192-2495

Phone

(703) 499-8787

Fax

(703) 499-8282

NPI assigned

Mar 18, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1164693164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 OLD BRIDGE RD",
            "address_2": "SUITE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922495",
            "telephone_number": "703-499-8787",
            "fax_number": "703-499-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 OLD BRIDGE RD",
            "address_2": "SUITE 103",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922495",
            "telephone_number": "703-499-8787",
            "fax_number": "703-499-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINE",
        "first_name": "KIMBERLY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "MED, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201000309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Audiologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.

Verify at the official NPI Registry.