Individual provider Active NPI

Kimberly Jones, MSOP, CPO

  • Orthotist
  • Redlands, CA
National Provider Identifier
1245979889
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
CPO03850
Practice address
1849 W Redlands Blvd Ste 103
Redlands, CA 92373-3127
Phone
(909) 798-5853
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X CPO03850
Orthotist 222Z00000X CPO03850 Primary

Addresses

Primary practice location

1849 W Redlands Blvd Ste 103
Redlands, CA 92373-3127

Mailing address

1849 W Redlands Blvd Ste 103
Redlands, CA 92373-3127
Phone (909) 798-5853

Other names 1

  • Ms. Kimberly Petersen Former name

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hanger Prosthetics & Orthotics West, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Redlands Prosthetic & Orthotic Group Inc Orthotist CurrentSince Nov 9, 2025 Accepting new patients
Redlands Prosthetic & Orthotic Group Inc Orthotist PastSince Nov 9, 2025 Accepting new patients
Hanger Prosthetics & Orthotics West Inc. Orthotist PastSince Jun 5, 2022 Accepting new patients

Locations

3024 W Florida Ave
Hemet, CA 92545
Phone (951) 766-7626

1849 W Redlands Blvd
Ste 103
Redlands, CA 92373
Phone (909) 798-5853

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1245979889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 W REDLANDS BLVD STE 103",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733127",
            "telephone_number": "909-798-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 W REDLANDS BLVD STE 103",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923733127",
            "telephone_number": "909-798-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "MSOP, CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": "CPO03850",
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": "CPO03850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PETERSEN",
            "prefix": "MS.",
            "credential": "MSOP, CPO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.