Gladys Cecilia Jimenez, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015087-1 Issued in NY

Practice address

6143 186TH St
Suite C113/114
Flushing, NY 11365-2710

Phone

(646) 325-8889

Fax

(347) 410-8174

NPI assigned

Nov 5, 2008

Last updated

Dec 4, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aspyr Speech Language Pathology Services, PC

  • Speech-Language Pathologist
  • Fresh Meadows, NY
  • NPI 1760701726
  NPD (past) Authorized official

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1346494259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14212 HOLLY AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552240",
            "telephone_number": "646-325-8889",
            "fax_number": "347-410-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "address_2": "SUITE C113/114",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "646-325-8889",
            "fax_number": "347-410-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "GLADYS",
        "middle_name": "CECILIA",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "015087-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Flushing, NY
• Providers in Flushing, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.