Individual provider Active NPI

Kimara Jenkins, SLP

  • Local Education Agency (LEA)
  • Little Rock, AR
National Provider Identifier
1396909669
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
SP#2031 Issued in AR
Practice address
25 Sheraton Dr
Little Rock, AR 72209-2045
Phone
(501) 447-5646
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X SP#2031 AR Primary

Addresses

Primary practice location

25 Sheraton Dr
Little Rock, AR 72209-2045

Mailing address

25 Sheraton Dr
Little Rock, AR 72209-2045
Phone (501) 447-5646

Other identifiers 1

IdentifierTypeStateIssuer
116837743MedicaidAR

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

State licenses

LicenseStateTypeSpecialty
SP#2031ARMDLocal Education Agency (LEA)

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1396909669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SHERATON DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092045",
            "telephone_number": "501-447-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SHERATON DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092045",
            "telephone_number": "501-447-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "KIMARA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "AR",
            "license": "SP#2031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116837743",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.