Kelly M Jimenez

Primary specialty

PharmacistTaxonomy code 183500000X

License

S017785 Issued in AZ

Practice address

5324 E Washington St
Phoenix, AZ 85034-2144

Phone

(602) 732-3384

NPI assigned

Aug 24, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Kelly M Dunaway Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Walgreens

  • Pharmacist
  • Phoenix, AZ
  • NPI 1164771820
  NPD (past)
• Walgreens Pharmacy

  • Pharmacist
  • Phoenix, AZ
  • NPI 1629486634
  NPD (past)

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1295041507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29774 N 69TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833173",
            "telephone_number": "219-808-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5324 E WASHINGTON ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342144",
            "telephone_number": "602-732-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26020635A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DUNAWAY",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittney Kianna Jimenez
• Chantel Therese P Jimenez, NP
• Dalisa Jimenez
• Diana Alexis Jimenez, FNP-C
• Isabel M Jimenez, M.D.
• Maria G Jimenez, RN
• Mayra Vanessa Jimenez, LMSW
• Megan Jimenez, FNP-C
• Savannah Jimenez, LCSW
• Sigrid Hazel D Jimenez, PHARMD

• Pharmacist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.