Active NPI
Kimberly Jackson-Small
- School Psychologist
- Richmond, VA
National Provider Identifier
1396249249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 301 N 9TH St
Richmond, VA 23219-1933 - Phone
- (804) 780-4449
- NPI assigned
- Mar 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
301 N 9TH St
Richmond, VA 23219-1933
Mailing address
PO Box 184
Tappahannock, VA 22560-0184
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1396249249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 184",
"city": "TAPPAHANNOCK",
"state": "VA",
"postal_code": "225600184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N 9TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232191933",
"telephone_number": "804-780-4449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON-SMALL",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-23",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.